Vulvovaginal candidiasis is one of the most frequent
infections of the female genital tract with a high incidence. Although numerous antimycotical agents are available for treatment of yeast
vaginitis, there are few comparative data on the in vivo and in vitro activity of these drugs. The aim of this open, randomized, and comparative study was to determine in vivo and in vitro effectiveness of the 3 systemic
antifungal agents:
terbinafine and 2
azoles (
itraconazole and
fluconazole) in the treatment of patients with
Vulvovaginal candidiasis. A total of 44 patients who had signs and symptoms of
Vulvovaginal candidiasis were recruited for the study. Patients were randomly assigned to 3 groups:
terbinafine 500 mg/d orally was used for 7 days,
itraconazole 200 mg/d orally was used for 7 days, and
fluconazole 150 mg orally was used as a single dose. Both clinical and mycologic examinations were performed for posttreatment assessment at week 4. This study revealed a clinical cure rate 33.3% for
terbinafine, 60% for
itraconazole, and 66.6% for
fluconazole (P>0.05). Mycologic cure rates were 33.3%, 10%, and 66.6% respectively (P<0.05). Overall cure rates were 33.3%, 10%, and 53.3% (P>0.05).
Terbinafine could be an alternative treatment option in
Vulvovaginal candidiasis because there were no significant differences in the clinical and overall cure rates among 3
antifungal agents. However,
terbinafine could not be suggested as a first-line treatment in
Vulvovaginal candidiasis. Systemic use of
terbinafine in larger numbers of cases may give more information about the effectiveness of this
drug in the treatment of patients with
vulvovaginal candidiasis.