Q: My 7-year-old daughter is suffering from finger nail fungal infection for the past 3 months. Her first doctor prescribed her Lamisil (terbinafine hydrochloride) 250 mg tablets, which we gave to her for a month. Since her doctor left for vacation, we took her to another dermatologist who prescribed hand wash with Lamisil tube twice daily. We are following this treatment since a month or so but there hasn't been any help. The dermatologist said tablet shouldn't be given to children. But, I see very little progress with the Lamisil ointment. What should I do? Should I go back to Lamisil 250 mg oral treatment or continue with Lamisil Ointment?

A:Getting rid of fungal infections of the nails is not an easy task and takes quite a bit of time. The problem is that oral terbinafine has not been tested for safety in children (through controlled clinical trials) and hence is not recommended for use in children. On the other hand, topical terbinafine is indicated for fungal infections of the skin in children over the age of 12 years since safety and efficacy below 12 years has not been studied. Thus in effect neither tablets nor topical form is recommended in a child of 7-8 years. However terbinafine for topical application is more acceptable compared to tablets for children.