Single-Dose Clotrimazole for Candidal Vaginitis Candidal vaginitis is the most frequent diagnosis made in patients who present to a primary care practice with complaints of vaginal discharge and pruritus. Treatment with imidazole derivatives, such as clotrimazole, is effective. The recommended duration of treatment has been reduced from seven to three days, without a decline in the cure rate. Single-dose treatment is now recommended in uncomplicated cases. In a multipractice study in Denmark, Bro evaluated the efficacy of a single dose of clotrimazole (500-mg tablet administered vaginally) in women with candidal vaginitis.
Ninety-five women were randomized to receive either single-dose clotrimazole (55 women) or placebo (40 women). All characteristics were similar in the two groups. Seven to ten days after treatment, all of the women were evaluated and a culture was performed. Five weeks after treatment, a questionnaire eliciting information about symptoms was administered.
On follow-up examination after the first visit, candidal species were isolated in specimens from 21 (38 percent) of the women treated with clotrimazole and from 30 (75 percent) of the women in the placebo group, a significant difference. Although the mycologic cure rate was superior in the treatment group, the symptomatic cure rate (as evaluated by the history and responses on the questionnaire) was not different in the two groups at both one and five weeks after treatment.
The author believes that clinical trials are needed to evaluate the treatment of candidal vaginitis in general practice settings. (Journal of Family Practice, August 1990, vol. 31, p. 148.)
COPYRIGHT 1991 American Academy of Family Physicians
COPYRIGHT 2004 Gale Group
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