Comment

I excluded one study that was still in progress.28 Another29 was excluded because it gave no separate clinical and mycological data for each study group. I found a study reported as an RCT29 in a group of New Zealand patients with mainly M. canis infections. The authors concluded that 4 weeks of terbinafine was as efficacious as 8 weeks of griseofulvin treatment, using topical econazole cream and ketoconazole shampoo as adjunct therapy. However, complete clinical and mycological data for study end and follow up time points were not provided. One RCT27 was presented as a duplicate publication.23 The manufacturer of terbinafine has been involved in most of the RCTs. Some uncontrolled studies have found oral terbinafine at higher doses or over 6-8 weeks to be effective in the treatment of M. canis tinea capitis and well tolerated.13 Definition of cure varies from study to study: some investigators follow microbiological findings, others place greater emphasis on clinical response. High dropout rates in some studies may artificially decrease the response rate, as those who are cured may be lost to follow up.

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