Comparison of Efficacy of Clotrimazol with Fluconazol in Vulvovaginal Candidiasis

It is estimated that as many as 75% of women experience at least one episode of vulvovaginal candidiasis during their lifetime. Candida albicans is responsible for 85 to 90% of vaginal yeast infections. Topically applied azoles are the most commonly available treatment for vulvovaginal candidiasis. In 80 to 90% of patients the symptoms usually take 2 to 3 day to resolve. Treatment with an oral antifungal agent, fluconazol, used in a single 150 mg dose has been approved for the treatment of vulvovaginal candidiasis, but symptoms do not disappear within 2 to 3 days. Due to fewer side effects and the ease of use of oral fluconazol the aim of this research was to compare the efficacy of oral fluconazol vaginal clotrimazol in the treatment of vulvovaginal candidiasis. Subjects and In this study 192 patients 97 patients were in vaginal clotrimazol group and 95 patients in fluconazol group with vulvovaginal candidiasis were divided randomly in two groups. Diagnosis of vulvovaginal candidiasis in these patients was based on typical clinical signs and symptoms, normal PH of vaginal discharge and microscopic findings including observation of budding-yeast forms or mycelia in 10 % KOH. The first group was treated by oral fluconazol (150 mg single dose) and the second group treated with vaginal clotrimazol for 1 week. The efficacy of drugs compared by chi-square test The Mean age of patients was 30 years. Response to treatment in vaginal clotrimazol group was 97% with 72% of patients responded in 1 to 3 days and 28% after 3 days. Response to treatment in fluconazol group was 86% with 94% of patients responded in 3 days and 6% after 3 days. This study reveals that therapeutic response in clotrimazol group was higher than fluconazol groups (P <0.05). However, contrary to other studies, the time of response in fluconazol group was faster (P <0.01). Therefore, according to these results, fluconazole produced efficacy in 86% of patient with faster rate of recovery. In addition, the ease of administration of fluconazol together with some disadvantages associated with use of vaginal clotrimazol, it is advised that the patients suffering from vulvovaginal candidiasis to be treated initially with oral fluconazol and in non-responders with vaginal clotrimazol.