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Intermittent local prophylaxis against recurrent vaginal candidosis
T E Bushell1, E G Evans, J D Meaden
1Royal West Sussex Hospital, Chichester.
Genitourinary Medicine
|October 1, 1988
Summary
Monthly clotrimazole prophylaxis can reduce symptomatic recurrences of vaginal candidosis. However, mycological recurrence remains high, indicating limited long-term efficacy for this fungal infection treatment.
Area of Science:
- Mycology
- Infectious Diseases
- Women's Health
Background:
- Recurrent vaginal candidosis (RVC) significantly impacts women's quality of life.
- Prophylactic strategies are crucial for managing RVC.
- Clotrimazole is a common antifungal agent used for vaginal candidosis.
Purpose of the Study:
- To evaluate the efficacy of monthly clotrimazole prophylaxis in preventing RVC.
- To compare different dosing frequencies of clotrimazole prophylaxis.
Main Methods:
- Women with RVC received initial treatment until infection cleared.
- Participants were randomized to receive either clotrimazole 500 mg vaginal tablets monthly or placebo.
- Subsequent analyses explored monthly and twice-monthly prophylaxis regimens for women who relapsed.
Main Results:
- Monthly clotrimazole prophylaxis reduced symptomatic recurrences compared to placebo within three months (9/17 vs. 16/21).
- Twice-monthly prophylaxis showed a higher rate of sustained clearance (10/17 clear for 12 months).
- Despite reduced symptoms, mycological recolonization occurred in over half of women across all groups within three months.
Conclusions:
- Monthly clotrimazole prophylaxis offers symptomatic relief for RVC.
- Higher frequency prophylaxis may improve sustained clearance.
- Current prophylactic regimens show limitations in preventing complete mycological eradication.