Comparison of the efficacy of clotrimazole and itraconazole in the treatment of acute vulvovaginal candidiasis

A clinical trial to compare the efficacy of clotrimazole and itraconazole in the treatment of vulvovaginal candidiasis. The clinical trial was conducted in the Gynecological outpatient clinic of the University Hospital Amir, Semnan, Iran between the 1st of June 2006 and 31st of June 2007. Vulvovaginal candidiasis was diagnosed by history, examination, smear and culture. Patients [N=264 cases] were divided in two groups. One group was treated with Itraconazole [400mg two divided dose] and the second with clotrimazole vaginal cream [5 grams daily; to be given over 6 days duration]. Patients was considered cured if there were no clinical signs of infection and the smear and culture were negative ten days after the treatment. Statistical analysis for significance was conducted using Student T, chi-square and exact Fisher tests using SPSS package. The mean age of itraconazole and clotrimazole groups were 28.1 +/- 4.8 and 28 +/- 5.8 and cure rates were 88% [110 case] and 81% [103 cases] respectively. There was increased frequency of micturations in 4 cases of itraconazole and 7 cases of clotimazole group and dyspareunia in 2 cases of itraconazole and 6 cases of clotimazole group.The satisfaction rates with treatment were 94.4% [118 cases] and 86% [109 cases] respectively. So, there wasn't any significant statistical difference in cure rate, side effects and satisfaction rate between the two groups. No difference was found in the cure rate for vaginal clotrimazole and oral itraconazole after the treatment of vulvovaginal candidiasis and the side effects of both drugs were minimal

Econazole and clotrimazole in the treatment of vaginal candidiasis: a double blind comparative study.

OBJECTIVES: To compare the efficacy of treatment with econazole and clotrimazole in patients with vaginal candidiasis. DESIGN: A double blind study. Patients with vaginal candidiasis were randomly treated with vaginal depot preparations of econazole and clotrimazole. Efficacy after treatment by reduction of symptoms, a gynaecological examination and microbiological analysis of vaginal fluid. Adverse reactions were noted. SETTING: University gynaecological clinic at the de Soysa Hospital for Women, Colombo. PATIENTS: 102 patients microbiologically confirmed as having vaginal candidiasis. RESULTS: Two weeks after econazole treatment 19% still complained of a discharge and 7.5% had pruritus. The respective values for clotrimazole were 18% and 12%. The finding on gynaecological examination generally supported the reduction of symptoms. Microbiological assessment showed that 90.5% in the econazole group and 96% in the clotrimazole group became culture negative at two weeks after treatment. Adverse effects were similar in incidence and number for both treatment groups. Econazole was less acceptable to patients than clotrimazole. CONCLUSIONS: Econazole and clotrimazole are of equal efficacy for treatment of vaginal candidiasis. Econazole was less acceptable to patients.