Comparison between therapeutic efficacy of itraconazole pulse therapy and terbinafine in treatment of tinea capitis in paediatric population.

Abstract

Objective: To compare the therapeutic efficacy of itraconazole pulse therapy and terbinafine in the treatment of tinea capitis in children. Study Design: Prospective, Randomized Controlled Trial. Setting: Department of Dermatology, Jinnah Hospital, Lahore, Pakistan. Period: April 2025 to September 2025. Methods: A total of 118 (59 in each group) children aged 3–14 years with clinically and mycologically confirmed tinea capitis, were randomized to itraconazole pulse therapy or continuous terbinafine. Primary outcome was therapeutic efficacy noted in terms of clinical and mycological cure at 8-weeks, while secondary outcomes were recorded as time to symptom relief and adverse events. Data were anlayzed using IBM-SPSS version 26.0, taking p<0.05 as significant. Results: Of 118 children enrolled, 68 (57.6%) were males, with a median age of 8.1 years (IQR 5.2–9.7). A total of 113 (95.8%) completed follow-up evaluation. Therapeutic efficacy was achieved in 97 (85.8%), clinical cure in 101 (89.4%), and mycological cure in 97 (85.8%). Efficacy was noted among 91.1% with itraconazole versus 80.7% with terbinafine (p=0.114). Adverse events included gastrointestinal disturbances in 11 (9.7%) and liver enzyme elevation in 3 (2.7%) patients while no one discontinued the treatment due to adverse events. Conclusion: Both itraconazole pulse therapy and terbinafine were found to be effective, well-tolerated, and safe options for the treatment of pediatric tinea capitis.