Fluconazole As a Prophylactic Measure for Tinea Gladiatorum in High School Wrestlers

Objective:To evaluate the use of prophylactic oral fluconazole in reducing the incidence of tinea gladiatorum in high school wrestlers. Design:A prospective longitudinal study was conducted on high school wrestlers in northwest Ohio between 1997 and 2007. Setting:Two northwest Ohio high school wrestling teams. Participants:High school wrestlers (373). Interventions:Prophylactic fluconazole at a daily oral dosage of 100 mg for a 3-day regimen prior to the onset of the competitive interscholastic wrestling season and 6 weeks into the wrestling season. Guardians of participants signed consent forms outlining the risks associated with fluconazole prior to being enrolled into the study. Main Outcome Measures:Incidence of tinea gladiatorum in participants. Results:Over the course of this 10-year study, out of 373 participants using prophylactic fluconazole, the incidence rate of tinea gladiatorum dropped from 67.4% to 3.5%. It should be noted that more than 50% of these infections occurred within the initial year of this study when the second administration of fluconazole was given at week 8 instead of week 6. No adverse effects were reported over the 10-year study period. Conclusions:The twice-per-season regimen of 100 mg daily for 3 days was highly effective in dramatically reducing the incidence of these skin lesions. The success of our study is 2-fold: First, fluconazole provided prophylaxis. Second, the overall incidence of fungal disease throughout the entire wrestling team was markedly decreased because most of the wrestlers participated in this study, significantly reducing exposure to these lesions through wrestling practice. No adverse effects in the use of fluconazole over this 10-year study period were reported.