These clinical pearls for griseofulvin use in children combine evidence-based insights with practical wisdom gained from decades of treating pediatric fungal infections. Understanding these key points helps optimize treatment success while avoiding common pitfalls.
Treatment duration for tinea capitis extended from 6 to 8-12 weeks due to increasing failures
6 weeks standard for all tinea capitis
8 weeks minimum, 12 weeks for T. tonsurans or treatment failures
Impact:
Terbinafine increasingly preferred over griseofulvin for tinea capitis
Griseofulvin first-line for all pediatric dermatophytoses
Terbinafine first-line, especially for T. tonsurans
Impact:
Routine adjunctive topical therapy now recommended for all tinea capitis
Topical therapy considered optional
Antifungal shampoo 2-3x/week standard of care
Impact:
5-year-old with tinea capitis from puppy (M. canis)
12-year-old with T. tonsurans tinea capitis, failed 6 weeks griseofulvin
Parent reports giving medicine with skim milk and fruit