Bibliographic information
GuidelineWHO recommendations on adolescent health: guidelines approved by the WHO guidelines review committee
Year of Publication2017
Issuing InstitutionWorld Health Organization
Recommendation
New
(In children and adults with extensive tinea infections or hair/nail involvement, oral griseofulvin should be considered) If there is no response, then oral terbinafine or itraconazole should be used.
Recommended in favor
Conditional
Certainty of evidence
Very low
Notes and Remarks
- 1)A variety of topical antifungals are considered efficacious. Topical miconazole and topical terbinafine are listed in the recommendations specifically as they are part of the WHO Model list of essential medicines.a
- 2)Griseofulvin: Griseofulvin may be used in children aged 2 years and older. Griseofulvin should be avoided in pregnancy as it may be teratogenic. It is labeled as a Pregnancy Category C drug. There is no evidence of excretion into human milk. Other side effects of griseofulvin include gastrointestinal upsets (which may be reduced by administration with food) and photosensitivity in some patients.
- 3)Ointment preparations are preferred for thickened, hyperkeratotic lesions. Lotions and solutions are preferred for intertriginous areas and hairy areas of the body, and also appropriate for treating moist, oozy, weepy lesions. Cream formulations are beneficial in the treatment of scaling, non-oozing lesions.
- 4)These recommendations apply to HIV-negative children and adults as well