Griseofulvin has been a traditional treatment for ringworm due to its long history of tolerance for safety and efficacy. This drug is active against Trichophyton tonsurans, the most common infectious agent, as well as against Microsporum spp., And is generally prescribed for a course of 6 to 8 weeks. Terbinafine is a relatively new antifungal drug that has pronounced activity against Trichophyton, but not against Microsporum, and can only be prescribed within 2 to 4 weeks by compared to 6 to 8 weeks. griseofulvin.

Ringworm is mainly caused by members of the genus Trichophyton and affects a large number of children living in American cities. Although oral griseofulvin is the drug of choice in such cases, the authors presented a meta-analysis of clinical trials comparing terbinafine and oral griseofulvin for the treatment of ringworm in children.

A search for randomized clinical trials was performed in the MEDLINE database. The selection criteria included oral administration of griseofulvin for at least 6 weeks and identification of pathogenic scalp dermatophytes at the time of their inclusion in the study. The results of a scalp culture study at least 8 weeks after inclusion were used as a criterion to assess the result. Determination of the overall odds ratio (OR) with a 95% confidence interval (CI), the Cochran-Mentel-Hensel difference significance test and the uniformity test were used for statistical analysis.

The authors found six publications that met all of the inclusion criteria. The studies were grouped by result at 12 and 16 weeks after inclusion. The total OR was 0.86 (95% CI 0.57-1.27). In the analysis of 5 studies in which Trichophyton spp. was the predominant pathogen, according to the results 12 weeks after inclusion, the results were close to indicating that terbinafine was superior (OR 0.65 [95% CI: 0.42-1.01]). For the results at 8 weeks after inclusion, the differences between the drugs have not been established (OR: 0.84 [95% CI: 0.54-1.32].

Thus, this meta-analysis showed that a 2-4 week course of terbinafine is as effective as a 6-8 week course of griseofulvin to treat a scalp infection caused by Trichophyton. Griseofulvin probably has advantages over terbinafine in rare cases caused by Microsporum spp.