Comparison between oral ketoconazole and topical miconazole in the treatment of vaginal candidiasis

Oral ketoconazole and topical miconazole were compared in the treatment of vaginal candidiasis, in an open trial. One group (n = 49) received of ketoconazole, 400 mg per day for 3 days, another group (n = 42) ketoconazole 200 mg per day for 6 days and the third (n = 49) miconazole vaginal tablets (100 mg) one per day for 14 days. One week after conclusion of the treatment the mycological cure rates (67%, 78% and 81%) were not statistically different from each other. The recurrence rates assessed one month after the treatment were also of same order (7%, 7% and 15%) and did not differ significantly from each other. Those patients who had previous had candidiasis showed lower cure rates than patients with their first vaginal candidiasis., following both miconazole and ketoconazole therapy. No adverse reactions attributable to the drugs were recorded. The advantages of ketoconazole in the treatment of vaginal candidiasis are: oral route of administration, short duration of the therapy (3-6 days), high therapeutic effectiveness and lack of any significant side effects.