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Fluconazole, Itraconazole Equally Effective In Vulvovaginal Candidiasis
A DGReview of :"Fluconazole 150 mg single dose versus itraconazole 200 mg per day for 3 days in the treatment of acute vaginal candidiasis: a double-blind randomized study."
European Journal of Obstetrics & Gynecology and Reproductive Biology
02/07/2003
By Anne MacLennan
Both fluconazole and itraconazole produce dramatic results within one week in women with acute vulvovaginal candidiasis (VVC), suggest researchers in Italy.
This study, from three university centres, found that each of the two oral antifungal agents showed good clinical and mycological efficacy on the acute VVC episode, achieving significant decrease of signs and symptoms after seven days of treatment.
Led by Dr C De Punzio from the Universita degli Studi di Pisa, these investigators compared safety and efficacy of fluconazole 150mg single dose and itraconazole 200mg per day for three days in 86 patients.
All of the patients in the double-blind randomised study had acute clinically and mycologically confirmed VVC. Of the 86, a total of 70 -- 38 on fluconazole and 32 on itraconazole -- were able to be evaluated.
By day 7, all but one of the fluconazole patients were cured or improved, and there was eradication of the baseline pathogen in all but two patients on itraconazole. At day 21, a 13% relapse rate was observed in both groups, with all other patients cured or improved and eradication rates of 76% for fluconazole and 66% for itraconazole.
Although global symptom scores (GSS) were significantly more severe at baseline in fluconazole patients, the slope of the GSS decrease between baseline and day seven was similar for both groups and, on the last visit, GSS were identical.
As for adverse events, 19 fluconazole patients reported 31, and 15 itraconazole patients reported 30.
The authors point out fluconazole in single dose warrants optimal compliance in patients who frequently experience more than one episode of VVC.
Eur J Obstet Gynecol Reprod Biol 2003 Feb;106:2:193-7.
"Fluconazole 150 mg single dose versus itraconazole 200 mg per day for 3 days in the treatment of acute vaginal candidiasis: a double-blind randomized study."
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