Single‐Dose Oral Fluconazole Versus Single‐Dose Topical Miconazole for the Treatment of Acute Vulvovaginal Candidosis

Heusden, Arne M. van; Merkus, Hans M.W.M.; Corbeij, Ruud S.A.C.M.; Oosterbaan, Herman P.; Stoot, J.E.G.M.; Ubachs, Hans M. H.; Verhoeff, Arie

doi:10.3109/00016349009013305

Cited by 16 publications

(4 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…They are as effective as intravaginal treatment of vulvovaginal candidiasis, but gastrointestinal toxicity resulting in nausea, vomiting, and diarrhea is common, occurring in up to 15% of patients. 45,46 One-dose topical treatments are also available (tioconazole 6.5% vaginal ointment, clotrimazole 500-mg vaginal suppository), but appear to have less efficacy than other preparations. 47 For patients with frequently recurrent candidal vaginitis, it is important to consider factors that predispose to infection.…”

Section: Treatmentmentioning

confidence: 99%

Evaluation and management of vaginitis

1998

View full text Add to dashboard Cite

V aginitis is a common medical problem in women that is associated with substantial discomfort and frequent medical visits. Roughly 5 to 10 million office visits per year are attributed to vaginitis. 1 Research in recent years has increased our understanding of the disease process and its potential sequelae and resulted in improved diagnostic and treatment modalities. 2-6 Nevertheless, adequate diagnosis and treatment of vaginitis in the office setting often is problematic for practitioners. 2,5,7-9 Moreover, the availability of over-the-counter medications for fungal vaginitis has increased the likelihood that women will come to medical attention with partially or inadequately treated infections. 10 We will focus on the common infectious causes of vaginal discharge-yeast infection, bacterial vaginosis, and trichomonas infection, emphasizing new developments in diagnosis, associated complications, and treatment of these infections.The initial evaluation of vaginal discharge requires an understanding of physiologic vaginal discharge and what differentiates it from abnormal, pathologic discharge. Substances from the vulvar, sebaceous, sweat, Bartholin's and Skene's glands, as well as exfoliated cells, cervical mucus, and secretions of the endometrial cavity and fallopian tubes constitute the normal physiologic secretions of the vagina. These secretions pool in the posterior fornix and do not adhere to the vaginal walls. 11 The pH of normal vaginal secretions in women of childbearing age is between 3.8 and 4.5. The presence of sperm, blood, amniotic fluid, or cervical mucus raises the vaginal pH. 11 The amount and fluidity of the discharge can vary over the menstrual cycle. Cervical mucus becomes more fluid around ovulation, and women frequently mistake this change in consistency for an abnormal discharge. Stress increases the rate of vaginal desquamation and thus the amount of discharge, which patients can also mistake for a pathologic discharge. 12 Women generally do not have other symptoms if their discharge is physiologic.In contrast, a pathologic discharge adheres to the vaginal walls and is often accompanied by irritation, pruritus, odor, or urinary symptoms such as dysuria or frequency. 6 The discharge can be thick to watery and frothy, and white to yellow, gray, or green. 11 Causes of an abnormal discharge include infectious causes of vaginitis such as yeast infection, bacterial vaginosis, and trichomonas infection, as well as cervicitis and sexually transmitted diseases such as gonorrhea and chlamydia infection. Noninfectious etiologies include chemical irritants such

show abstract

Section: Treatmentmentioning

confidence: 99%

Evaluation and management of vaginitis

1998

View full text Add to dashboard Cite

show abstract

“…The Centers for Disease Control and Prevention recommend two doses of oral fluconazole 150 mg to treat SVVC [3]. Several studies have demonstrated that uncomplicated VVC responds well to a single dose of miconazole nitrate vaginal suppository 1,200 mg [4,5,6,7,8,9]. The effect of miconazole nitrate vaginal suppository 1,200 mg on SVVC is not known.…”

Section: Introductionmentioning

confidence: 99%

Miconazole Nitrate Vaginal Suppository 1,200 mg versus Oral Fluconazole 150 mg in Treating Severe Vulvovaginal Candidiasis

Fan

Liu²,

Liang³

2015

Gynecol Obstet Invest

View full text Add to dashboard Cite

Aims: Miconazole is a synthetic imidazole antifungal that has a broad spectrum of activity against Candida albicans and non-albicans Candida species. The aim of this study was to evaluate the efficacy and safety of miconazole nitrate vaginal suppository and oral fluconazole in treating severe vulvovaginal candidiasis (SVVC). Methods: In this prospective, randomized case control study, 577 cases of consecutive patients with SVVC were studied at the Gynecological Clinic of Peking University Shenzhen Hospital from January 1, 2009 through December 31, 2010. Patients with SVVC were treated with two doses of miconazole nitrate vaginal suppository 1,200 mg or two doses of fluconazole 150 mg. The patients were followed up for 7-14 and 30-35 days following the second dose of therapy. Results: The mycological cure rates of the patients on days 7-14 of follow-up were 75.9% (220/290) and 84.0% (241/287) in the miconazole and fluconazole groups, respectively (p < 0.05). The mycological cure rates of the patients at the second follow-up were 64.8% (188/290) and 69.7% (200/287), respectively, in the two groups (p > 0.05). Conclusion: The study demonstrated that two doses of miconazole nitrate vaginal suppository 1,200 mg were as effective as two doses of an oral fluconazole 150 mg regimen in the treatment of patients with SVVC.

show abstract

“…From the clinical point of view, the study incorporates some new aspects to measure therapeutic response. In most drug-efficacy studies, clinical cure is assessed after 7 days [ 12 , 17 , 18 , 20 ], and after 5-16 days [ 11 , 35 , 36 ] but we think it is interesting to evaluate the time for the relief of symptoms, since there is disagreement about whether the symptoms were relieved earlier with oral or topical drugs. In this way, Seidman LS [ 37 ] reported that the relief of symptoms is 24 hours with topics and 46 hours with orals.…”

Section: Discussionmentioning

confidence: 99%

“…Ten clinical trials dealt with women's preference regarding the anti-fungals way of administration, but the presented data were not sufficient to answer this question [ 10 - 20 ]. The Cochrane review's authors concluded that all studies that dealt with preferences are in favor of oral treatment (compared to intravaginal or no preference) with a fluctuation from 43% for women at Van Heusdenal's trial [ 20 ] to 93% at Timonen's trial [ 16 ]. Nevertheless, inconsistencies associated with the report of the preferred way of administration limit the use of such data.…”

Section: Introductionmentioning

confidence: 99%

Patient preferences and treatment safety for uncomplicated vulvovaginal candidiasis in primary health care

González

Cuesta

et al. 2011

BMC Public Health

View full text Add to dashboard Cite

BackgroundVaginitis is a common complaint in primary care. In uncomplicated candidal vaginitis, there are no differences in effectiveness between oral or vaginal treatment. Some studies describe that the preferred treatment is the oral one, but a Cochrane's review points out inconsistencies associated with the report of the preferred way that limit the use of such data. Risk factors associated with recurrent vulvovaginal candidiasis still remain controversial.Methods/DesignThis work describes a protocol of a multicentric prospective observational study with one year follow up, to describe the women's reasons and preferences to choose the way of administration (oral vs topical) in the treatment of not complicated candidal vaginitis. The number of women required is 765, they are chosen by consecutive sampling. All of whom are aged 16 and over with vaginal discharge and/or vaginal pruritus, diagnosed with not complicated vulvovaginitis in Primary Care in Madrid.The main outcome variable is the preferences of the patients in treatment choice; secondary outcome variables are time to symptoms relief and adverse reactions and the frequency of recurrent vulvovaginitis and the risk factors. In the statistical analysis, for the main objective will be descriptive for each of the variables, bivariant analysis and multivariate analysis (logistic regression).. The dependent variable being the type of treatment chosen (oral or topical) and the independent, the variables that after bivariant analysis, have been associated to the treatment preference.DiscussionClinical decisions, recommendations, and practice guidelines must not only attend to the best available evidence, but also to the values and preferences of the informed patient.

show abstract

Single‐Dose Oral Fluconazole Versus Single‐Dose Topical Miconazole for the Treatment of Acute Vulvovaginal Candidosis

Abstract: A single dose fluconazole is as safe and effective as a single dose of miconazole.

Cited by 16 publications

References 18 publications

Evaluation and management of vaginitis

Evaluation and management of vaginitis

Miconazole Nitrate Vaginal Suppository 1,200 mg versus Oral Fluconazole 150 mg in Treating Severe Vulvovaginal Candidiasis

Patient preferences and treatment safety for uncomplicated vulvovaginal candidiasis in primary health care

Contact Info

Product

Resources

About