Response to Initial Griseofulvin Therapy in Pediatric Patients with Tinea Capitis
Response to Initial Griseofulvin Therapy in Pediatric Patients with Tinea Capitis
复制标题
头癣儿科患者对初始灰黄霉素治疗的反应
DOI：
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发表时间：
1997
期刊：
影响因子：
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通讯作者：
D. Powell
中科院分区：
文献类型：
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作者：
S. Abdel‐Rahman;M. Nahata;D. Powell
目的 评估头癣儿科患者对初始灰黄霉素治疗的反应率，并确定对治疗反应积极和消极的患者之间的临床或流行病学变量是否存在差异。方法对确诊为头癣的患者两年内的病历进行回顾性回顾。仅当获得阳性皮肤癣菌培养物并且在我们的药房配了灰黄霉素的初始处方时才纳入患者。响应者是没有返回诊所或返回时没有感染迹象或症状的儿童。无反应者是指 8 个月内返回并出现疾病体征和症状、需要额外治疗的人。结果1993年7月至1995年6月，我院474例患者真菌培养阳性479份，为765例患者配发灰黄霉素处方857张。在符合这两个标准的 122 名可评估患者中，60.7% 被列为对初始处方治疗有反应的患者。其余 39.3% 的患者在初始治疗后 8 个月内返回诊所，需要额外治疗。另外 10.7% 的患者后来复发。尽管有反应者的治疗持续时间有延长的趋势，但临床反应与剂量、年龄、种族或性别之间没有相关性。结论 城市儿童头癣持续存在。我们的数据表明，目前的首选药物灰黄霉素可能对至少三分之一的头癣儿科患者无效。
Objective To estimate the response rate to initial griseofulvin therapy in pediatric patients with tinea capitis and to determine whether clinical or epidemiologic variables differed between patients responding positively and negatively to therapy. Methods A review of patients' medical records with a confirmed diagnosis of tinea capitis was performed retrospectively over a 2-year period. Patients were included only if a positive dermatophyte culture was obtained and the initial prescription for griseofulvin was filled at our pharmacy. Responders were children not returning to the clinic or returning without signs or symptoms of infection. Nonresponders were those returning within 8 months with signs and symptoms of disease, requiring additional therapy. Results During July 1993-June 1995, 479 positive fungal cultures were confirmed in 474 patients, and 857 prescriptions for griseofulvin were filled for 765 patients at our institution. Of 122 evaluable patients meeting both criteria, 60.7% were classified as responders to initial prescribed therapy. The remaining 39.3% returned to the clinic within 8 months of initial therapy, requiring additional treatment. An additional 10.7% had a recurrence at a later date. There was no correlation between clinical response and dosage, age, race, or gender, although there was a trend toward longer treatment duration among responders. Conclusions It is evident that tinea capitis persists in the urban pediatric population. Our data suggest that griseofulvin, the current drug of choice, may be ineffective in at least one-third of pediatric patients with tinea capitis.