Comparison of Fluconazole and Clotrimazole in the Treatment of Acute Candida Albicans Vulvovaginitis

Abstract

Objective: This study compared two antifungal drugs, fluconazole and clotrimazole for the treatment of vulvo vaginal candidiasis. Materials and Methods: This randomized clinical trial was conducted on 120 women with vulvo vaginal candidiasis during a six month period. All patients answered a standard questionnaire containing questions about symptoms of vulvovaginal candidiasis and presence of vaginal discharge and signs of vulvar and vaginal inflammation were documented according to physical examination. Two swabs of vaginal discharge were obtained for each woman, one for direct smear, another for culture. The culture medium was Sabouraud Dextrose Agar (SDA). Patients were randomized into two groups of clotrimazole (vaginal cream for 7 days and 150 mg fluconazole in a single dose. Clinical and paraclinical responses were calculated. Results: Clinical improvement occurred in 96 cases (80%). This value was 86.7% and 73.3%for clotrimazole and fluconazole, respectively (P-value=0.04). Paraclinical response on tenth day of treatment was observed in 87 patients (72.5%). This value was 66.7% and 78.3%for clotrimazole and fluconazole groups, respectively (P-value=0.110). Mean days of treatment was 4.06 ±1.30 days for clotrimazole and 2.70 ±0.78 days for fluconazole (p value =0.031). Conclusion: Most of the clinical and paraclinical responses to the drugs used for the treatment of vulvo vaginal candidiasis are in the favour of fluconazole.

Keywords

• Vulvo vaginal candidiasis
• Candida albicans
• Fluconazole
• Clotrimazole