***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Treatment of children with tinea capitis currently consists of griseofulvin given orally for 1 to 3 months . Ketoconazole , a newer antifungal , is effective therapy for a variety of systemic mycoses . A r and omized doubleblind , placebo-controlled study was undertaken to compare ketoconazole and griseofulvin treatments of children with tinea capitis . Twenty-two patients were enrolled , and 14 completed the protocol . All patients had positive initial mycologic cultures . Seven evaluated patients received each drug . The treatment groups were comparable in terms of age , weight , sex , race , duration of infection , length of therapy , and initial disease severity . Adverse reactions occurred in three ketoconazoletreated patients and in none receiving griseofulvin . After 6 weeks of therapy , ketoconazole-treated patients had improved as much as griseofulvin-treated patients and were as likely to have negative mycologic cultures .  Ketoconazole shows promise as an alternative to griseofulvin for treating children with tinea capitis Background Tinea capitis is a common childhood infection that has recently become more frequent in urban areas in Europe and the U.S.A. The current licensed treatment in children is griseofulvin 10 mg kg−1 daily , which is usually given for 6–8 weeks BACKGROUND Tinea capitis is a fungal infection in which topical therapy is often unsuccessful . Griseofulvin has been considered to be a first-line therapy . Other antifungal agents are the azole derivatives . Among these , itraconazole was compared with griseofulvin in children in a double-blind study . PATIENTS AND METHODS Thirty-four children and one adult with clinical signs and symptoms of tinea capitis and with positive culture and microscopy for dermatophytes have been included in a double-blind comparison between itraconazole , 100 mg daily , and ultramicronized griseofulvin , 500 mg daily . Both drugs were given for 6 consecutive weeks . The final evaluation was made 8 weeks after the end of treatment to allow the hairs to regrow . Seventeen itraconazole- and 15 griseofulvin-treated patients received the complete 6-week treatment course . Fifteen of these 17 itraconazole patients and 14 of the 15 griseofulvin patients had infections caused by Microsporum canis . Fifteen of 17 patients were cured by itraconazole ( 88 % ) and 15 of 17 patients by griseofulvin ( 88 % ) . One of the patients who discontinued griseofulvin therapy after 4 weeks was clinical ly and mycologically cured . Two of the original 17 griseofulvin patients discontinued therapy because of vomiting . None of the itraconazole-treated children experienced side effects . CONCLUSIONS Itraconazole is the first azole derivate that matches griseofulvin for the treatment of tinea capitis in children . The drug also appears to be better tolerated than griseofulvin Mycotic scalp infection caused by Microsporum canis is the most dominant cause of tinea capitis in Greece .  Griseofulvin has been the gold st and ard for the treatment of tinea capitis , but it is unavailable in our country . In this study , we evaluated 111 children with M. canis tinea capitis that were treated with itraconazole .  Eighty-one of them were treated with itraconazole capsule pulse therapy ( group A ) and 30 ( group B ) were treated with oral suspension administered in continuous regimen . Twenty-one patients , all from group A , were lost to follow-up , probably due to the length of this regimen . In all patients that made up the study protocol , complete cure was achieved within seven pulses for group A and 12 weeks for group B. No significant side effects to lead to the cessation of therapy were recorded . Laboratory investigations were performed in 32 r and omly chosen patients and were within normal ranges . The response to therapy did not appear to depend upon the formulation administered ( capsules versus suspension ) . Using the pulse regimen , we also believe that it is necessary to individualize the number of pulses administered according to the clinical response . In conclusion , itraconazole proved safe and effective in our study , providing an ideal alternative to griseofulvin BACKGROUND Griseofulvin has been used for many years in the treatment of tinea capitis . Increase in resistance to this medication has led to a search for new therapeutic alternatives . OBJECTIVE Our purpose was to evaluate the therapeutic efficacy of terbinafine in comparison with griseofulvin in the treatment of tinea capitis . METHODS We performed a double-blind , r and omized , prospect i ve evaluation of 50 patients with a clinical and mycologic diagnosis of tinea capitis . One group received 4 weeks of terbinafine followed by 4 weeks of placebo . The other group received 8 weeks of griseofulvin . We evaluated 5 clinical parameters . Mycologic examinations were performed at baseline and at the end of weeks 8 and 12 . RESULTS Patients ' ages ranged from 1 to 14 years . Fifty-four percent were girls and 46 % were boys . Mycologic examinations disclosed Trichophyton tonsurans in 74 % of patients and Microsporum canis in 26 % . At week 8 , the griseofulvin-treated group showed a cure rate of 76 % , and the terbinafine-treated group 72 % . At week 12 , the efficacy of griseofulvin  decreased to 44 % , whereas the efficacy of terbinafine was 76 % . CONCLUSION Terbinafine constitutes an alternative for the treatment of tinea capitis . Recurrences were less frequent . No significant side effects were reported OBJECTIVES Terbinafine has been shown to be effective in tinea capitis , using different treatment duration s. However , no direct comparison of treatment duration has previously been investigated . This r and omized , double-blind , parallel-group , multicenter study was design ed to assess the effect of terbinafine treatment duration on the outcome of Trichophyton tinea capitis in a North American population . METHODS A total of 176 patients with a clinical diagnosis of tinea capitis were enrolled in this study and treated with oral terbinafine ( 3 - 6 mg/kg/d ) for 1 , 2 , or 4 weeks . All patients were to be followed until week 12 . A total of 159 patients had culture-confirmed tinea capitis attributable to Trichophyton species and constituted the intent-to-treat population used for efficacy analysis ( 50 , 55 , and 54 patients in the 1- , 2- , and 4-week arms , respectively ) . RESULTS At the end of study , effective treatment , defined as negative culture and low scores on signs and symptoms , was achieved in 56 % , 69 % , and 65 % of patients who were treated with terbinafine for 1 , 2 , and 4 weeks , respectively . A negative culture was achieved in 60 % , 76 % , and 72 % , respectively . Overall , the efficacy data showed that both the 2- and 4-week treatment regimens are clinical ly superior to the 1-week regimen . Terbinafine was well tolerated , and the incidence of adverse events showed no relationship to the duration of therapy . CONCLUSION When efficacy , cost , and compliance are taken into consideration , 2 weeks of terbinafine therapy appears to be the optimal treatment duration for patients with Trichophyton tonsurans tinea capitis Fluconazole , a water soluble bis-triazole , is a highly selective inhibitor of fungal cytochrome P450 and sterol 14-alpha demethylation . It has good bioavailability , low protein binding , and a long half-life . After oral administration it rapidly distributes to the subcutaneous tissues and epidermis , where it accumulates . Favorable results have been obtained with fluconazole in the treatment of various systemic mycoses , c and idiasis , and dermatophyte infections . We studied the efficacy of fluconazole in the treatment of tinea capitis in children Mycotic scalp infection caused by Microsporum canis is one of the more recalcitrant disorders , with increasing incidence during the last decade . We report our experience with administration of itraconazole in 163 children ( 86 girls , 77 boys ) with M. canis tinea capitis . Fifty-five patients had previous treatment with terbinafine without success . In all children , the dosage of itraconazole was adjusted according to body weight , with 5 mg/kg/day given in a continuous regimen either as a capsule ( 116 patients ) or an oral suspension ( 47 patients ) . In all children , there was both clinical and mycologic cure after a mean treatment period of 39 + /- 12 days ( range 10 - 77 days ) . Eleven children ( 6.7 % ) had side effects : diarrhea in five children , cutaneous eruption in four , and abdominal pain in two . Itraconazole was effective and safe for the treatment of M. canis tinea capitis Objective To compare the efficacy and safety of terbinafine with griseofulvin in the treatment of tinea capitis in Western China . Methods Children ( 2–14 years of age ) with clinical ly diagnosed and potassium hydroxide microscopy – confirmed tinea capitis were r and omized into three groups : group GRI4 received 4 weeks of griseofulvin ; group TBF2 received 2 weeks of terbinafine ; and Group TBF4 received 4 weeks of terbinafine .  Clinical and mycological evaluations were done in 0 , 2 , 4 , and 8 weeks and 1 year after therapy started . The isolated pathogenic fungi were evaluated for in vitro susceptibility by detecting the minimal inhibitory concentration ( MIC ) against terbinafine , griseofulvin , itraconazole , and ketoconazole . Results The clinical effectiveness rate of GRI4 , TBF2 , and TBF4 were 100 % ( 95 % CI-confidence interval : 82–100 % ) , 96.3 % ( 95 % CI : 81–100 % ) , and 100%(95 % CI : 85–100 % ) , respectively , at week 8 and 100 % after 1 year for the 3 groups ; clinical cure rates were 84.2%(95 % CI : 77–99 % ) , 85.2%(95 % CI : 71–98 % ) , and 78.3%(95 % CI : 61–95 % ) , respectively , at week 8 and 100 % after 1 year for all agents ; mycological cure rates were 100%(95 % CI : 74–100 % ) , 95.0%(95 % CI : 74–100 % ) , and 94.1%(95 % CI : 50–93 % ) at week 8 and 100 % after 1 year for the 3 groups . In vitro , all patient-derived cultures were sensitive to the four antifungal agents . Conclusion Data from the clinical trial and in vitro antifungal activity indicated that terbinafine  is efficacious and well tolerated in the treatment for Trichophyton infections ( T. violaceum ; Arthroderma vanbreuseghemii ; and T. tonsurans ) of the scalp , i.e. , a 2- to 4-week course of terbinafine is as effective as a 4-week course of griseofulvin ; in fact , a 2-week course of terbinafine is sufficient . Terbinafine is an effective alternative to griseofulvin against tinea capitis of Trichophyton infections Summary Background Tinea capitis , a common clinical pattern of dermatophyte infection in children is becoming a public health hazard in some countries . Several studies have reported terbinafine to be a safe and well‐tolerated fungicidal drug for the treatment of this infection . However , the optimal treatment duration for its use in the treatment of tinea capitis caused by Microsporum species has not yet been determined To compare the efficacy and safety of fluconazole and griseofulvin in the treatment of tinea capitis Ketoconazole and griseofulvin were compared in a double blind fashion in 47 children with dermatophytosis and positive fungal culture . After 6 weeks of therapy there was clinical and mycologic cure or improvement of the lesions in 92 % of patients treated with ketoconazole ( Group A ) and in 76 % of those given griseofulvin ( Group B ) . A patient in Group A showed clinical deterioration of the lesions after 4 weeks of treatment , although modification of antifungal therapy was not necessary to achieve final healing . One ketoconazole-treated patient relapsed within 7 days after cessation of therapy . In Group B the antifungal agent was changed in five cases due to worsening or slow resolution of the lesions and persistence of positive cultures after 6 weeks of treatment . Both ketoconazole and griseofulvin were useful drugs for treatment of dermatophytoses in children BACKGROUND Although griseofulvin is currently considered the primary antifungal agent used to treat tinea capitis in many countries , increasingly higher doses and longer duration s of treatment are becoming necessary to achieve effective treatment . Alternative antifungal therapies with shorter/simpler treatment regimens may be important to develop for this indication . OBJECTIVE To compare the efficacy and safety of a new pediatric formulation of terbinafine hydrochloride oral granules with griseofulvin oral suspension in the treatment 
    Output:
    
Newer treatments including terbinafine , itraconazole and fluconazole are at least similar to griseofulvin in children with tinea capitis caused by Trichophyton species .
Limited evidence suggests that terbinafine , itraconazole and fluconazole have similar effects , whereas ketoconazole may be less effective than griseofulvin in children infected with Trichophyton .
New evidence from this up date suggests that terbinafine is more effective than griseofulvin in children with T. tonsurans infection .
However , in children with Microsporum infections , new evidence suggests that the effect of griseofulvin is better than terbinafine .
We did not find any evidence to support a difference in terms of adherence between four weeks of terbinafine versus eight weeks of griseofulvin .