What is the treatment for tinea faciei in a 40lb child?

From the Guidelines

Treatment for Tinea Faciei in a 40lb Child

Tinea faciei in a 40lb child should be treated with oral antifungal agents as first-line therapy, considering the child's weight and the severity of the infection 1.

First-Line Therapy

Given the child's weight (40lb), which is approximately 18kg, terbinafine is a suitable option, with a recommended dose of 125 mg per day for 2-4 weeks 1. This choice is based on the efficacy of terbinafine against common dermatophytes causing tinea faciei and its favorable treatment duration, which may enhance compliance.

Alternative Options

If terbinafine is not suitable, griseofulvin could be considered, although it is more commonly recommended for infections caused by Microsporum species 1. The dose for griseofulvin in a child under 50kg is 15-20 mg/kg/day, which for an 18kg child would be approximately 270-360 mg/day, given in a single or divided dose for 6-8 weeks 1.

Important Considerations

• Topical therapy alone is not recommended for tinea capitis but may be considered for tinea faciei, especially for mild cases or in combination with oral therapy 1.
• Treatment failure should prompt consideration of lack of compliance, suboptimal absorption, relative insensitivity of the organism, or reinfection, before switching to second-line therapies like itraconazole 1.
• Monitoring for mycological clearance is essential to determine the end point of treatment 1.

From the FDA Drug Label

DOSAGE AND ADMINISTRATION ... Pediatric patients (older than 2 years): A dosage of 10 mg/kg daily is usually adequate (pediatric patients from 30 to 50 lbs, 125 mg to 250 mg daily;

Representative treatment periods are ... tinea faciei is not listed, however tinea corporis, 2 to 4 weeks;

The treatment for tinea faciei in a 40lb child is 10 mg/kg daily of griseofulvin, which would be 200 mg to 250 mg daily in divided doses, for a treatment period of at least 2 to 4 weeks similar to tinea corporis, however the exact duration should be individualized and the medication must be continued until the infecting organism is completely eradicated as indicated by appropriate clinical or laboratory examination 2.

From the Research

Treatment Options for Tinea Faciei

There are no research papers to assist in answering this question as the provided studies focus on tinea capitis, tinea corporis, and other superficial fungal infections, but not specifically on tinea faciei.

Available Information on Superficial Fungal Infections

• The treatment for superficial fungal infections, such as tinea capitis, typically involves oral or topical antifungal agents 3, 4, 5, 6, 7.
• Terbinafine is an effective antifungal agent for the treatment of various superficial fungal infections, including tinea capitis 4, 6, 7.
• The dosage and duration of treatment with terbinafine may vary depending on the specific infection and patient population 4, 6.
• Topical treatment with antifungal agents, such as terbinafine, can be effective for superficial fungal infections, including tinea corporis and tinea cruris 5, 7.

Considerations for Treatment in Children

• When treating children, it is essential to consider the child's weight and age when determining the dosage of antifungal agents 3, 6.
• Terbinafine has been shown to be effective and well-tolerated in children with tinea capitis 6, 7.
• The treatment duration and dosage may need to be adjusted based on the severity of the infection and the child's response to treatment 6.