A patient has been taking griseofulvin for 4 weeks to treat a tineal capitis infection. The primary care NP notes improvement but not complete cure. The NP should:
a. obtain a culture and change to ketoconazole.
b. add a topical antifungal cream and refill the griseofulvin prescription for 2 weeks.
c. renew the prescription after obtaining renal, liver, and hematopoietic tests.
d. prescribe griseofulvin for 4 more weeks and then re-evaluate the infection.
C
Tineal infections may take 6 weeks to respond to griseofulvin. Patients taking griseofulvin longer than 4 weeks should have renal, hepatic, and hematopoietic functions monitored periodically. Topical antifungals typically are not effective for tinea capitis. Ketoconazole is usually not effective for tinea capitis.
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