Clotrimazole treatment of recurrent and chronic candida vulvovaginitis.
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| Abstract |
The management of women with recurrent and chronic vulvovaginal candidiasis continues to present a therapeutic challenge. In a prospective double-blind randomized study of 42 women with recurrent candidal vaginitis, clotrimazole 500-mg vaginal suppositories, administered once weekly for 2 weeks, induced clinical remission in 38 patients (90.4%) and achieved mycologic negative status in 83% of subjects. Thereafter, asymptomatic patients were randomized to receive monthly prophylactic vaginal tablets of clotrimazole 500 mg or placebo once a month. During the prophylactic phase, patients receiving placebo developed recurrences of symptomatic candida vaginitis at an extremely high rate, such that only one-third remained asymptomatic at the end of 6 months. In comparison, patients receiving clotrimazole demonstrated moderate protection from recurrence; which was maximal and statistically significant during the first 3 months of prophylaxis only (P less than .05). During the prophylactic period overall, attack rates were reduced by one-third with clotrimazole. No adverse reactions were observed with the administration of clotrimazole. In summary, clotrimazole therapy was successful in inducing an initial therapeutic response, but achieved only a modest long-term protective effect. Additional clinical benefit may be possible with more frequent clotrimazole prophylactic administration.
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| Authors | J D Sobel, C Schmitt, C Meriwether |
| Journal | Obstetrics and gynecology (Obstet Gynecol) Vol. 73 Issue 3 Pt 1 Pg. 330-4 (Mar 1989) ISSN: 0029-7844 [Print] United States |
| PMID | 2644595 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial) |
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