Vulvovaginal candidiasis treatment with local clotrimazole
Vulvovaginal candidiasis is a widespread disease that affects apparently healthy women of childbearing age, which enhances the social significance of this disease. It manifests itself by symptoms, such as itching, burning, pain, redness, and genital discharge, which significantly affects quality of life in patients. According to clinical practice guidelines, azoles should be intravaginally used to treat uncomplicated vulvovaginal candidiasis. The efficiency of therapy for this disease with different azoles is comparable; therefore, the treatment should be chosen on the basis of criteria, such as tolerability, patient convenience, etc. Of all the azoles that can be used to treat vulvovaginal candidiasis, clotrimazole has the best tolerance. There are also topical drugs containing local anesthetics and antiseptics to relieve itching and burning, but many women report discomfort during their use and the absence of the expected effect. A number of authors also emphasize that the use of a combination of clotrimazole with topical corticosteroids unreasonably and frequently enhance the manifestations of the fungal infection. Thus, as compared with clotrimazole monotherapy, combination local therapy with various drugs may apparently have a number of disadvantages.Apolikhina I.A., Ramazanova M.O.
Conclusion: Clotrimazole cream 2% shows high efficiency and safety confirmed in numerous Russian and foreign studies and can be recommended for use in patients with vulvovaginal candidiasis. The paper presents own clinical case of successful clotrimazole monotherapy of a patient with candidiasis vulvovaginitis on the basis of the Department of Aesthetic Gynecology and Rehabilitation, V.I. Kulakov NMRC for OG&P, Ministry of Health of Russia.
Keywords
vulvovaginal candidiasis
clotrimazole
azoles
urogenital candidiasis
References
- Willems H.M.E., Ahmed S.S., Liu J., Xu Z., Peters B.M. Vulvovaginal candidiasis: a current understanding and burning questions. J. Fungi (Basel). 2020; 6(1): 27. https://dx.doi.org/10.3390/jof6010027.
- Denning D.W., Kneale M., Sobel J.D., Rautemaa-Richardson R. Global burden of recurrent vulvovaginal candidiasis: A systematic review. Lancet Infect. Dis. 2018; 18(11): e339-e347. https://dx.doi.org/10.1016/S1473-3099(18)30103-8.
- Российское общество акушеров-гинекологов. Клинические рекомендации по диагностике и лечению заболеваний, сопровождающихся патологическими выделениями из половых путей женщин. М.; 2019.
- Crowley P.D., Gallagher H.C. Clotrimazole as a pharmaceutical: past, present and future. J. Appl. Microbiol. 2014; 117(3): 611-7. https://dx.doi.org/10.1111/jam.12554.
- Reef S.E., Levine W.C., McNeil M.M., Fisher-Hoch S., Holmberg S.D., Duerr A. et al. Treatment options for vulvovaginal candidiasis, 1993. Clin. Infect. Dis. 1995; 20(Suppl. 1): S80-90. https://dx.doi.org/10.1093/clinids/20.supplement_1.s80.
- Sobel J.D. Factors involved in patient choice of oral or vaginal treatment for vulvovaginal candidiasis. Patient Prefer. Adherence. 2013; 8: 31-4.https://dx.doi.org/10.2147/PPA.S38984.
- Fan L.Y., Liu Z.H., Bai X.N., Zong X. Analysis of resistance and sensitivity of 1 200 strains of vulvovaginal candidiasis in China to five common antifungal drugs. Zhonghua Fu Chan Ke Za Zhi. 2022; 57(8): 601-7. https://dx.doi.org/10.3760/cma.j.cn112141-20220211-00076.
- Мгерян А.Н. Вульвовагинальный кандидоз: эффективность терапии клотримазолом. Эффективная фармакотерапия. 2019; 15 (26): 36-41. [Mgeryan A.N. Vulvovaginal candidiasis: efficacy of clotrimazole therapy. Effective pharmacotherapy. 2019; 15 (26): 36-41. (in Russian)].https://dx.doi.org/ 10.33978/2307-3586-2019-15-26-36-41.
- Mendling W., Atef El Shazly M., Zhang L. Clotrimazole for vulvovaginal candidosis: more than 45 years of clinical experience. Pharmaceuticals (Basel). 2020; 13(10): 274. https://dx.doi.org/10.3390/ph13100274.
- Рахматулина М.Р., Тарасенко Э.Н., Большенко Н.В. Опыт применения препарата клотримазол 2%, крем, в терапии вульвовагинального кандидоза: результаты наблюдательного исследования. Акушерство и гинекология. 2020; 11: 206-12. [Rakhmatulina M.R., Tarasenko E.N., Bolshenko N.V. Experience with clotrimazole 2% cream in the therapy of vulvovaginal candidiasis: results of observational study. Obstetrics and Gynecology. 2020; 11: 206-12. (in Russian)]. https://dx.doi.org/10.18565/aig.2020.11.206-212.
- Ahangari F., Farshbaf-Khalili A., Javadzadeh Y., Adibpour M., Sadeghzadeh Oskouei B. Comparing the effectiveness of Salvia officinalis, clotrimazole and their combination on vulvovaginal candidiasis: A randomized, controlled clinical trial. J. Obstet. Gynaecol. Res. 2019; 45(4): 897-907.https://dx.doi.org/10.1111/jog.13918.
- Mohammadi S., Pajohideh Z.S., Iravani M., Mojab F., Maraghi E. Comparing the effectiveness of Arnebia euchroma with clotrimazole vaginal cream for the treatment of vulvovaginal candidiasis: a randomized controlled triple-blind trial. Iran. J. Nurs. Midwifery Res. 2022; 27(2): 112-8. https://dx.doi.org/10.4103/ijnmr.ijnmr_330_20.
- Tiboni M., Campana R., Frangipani E., Casettari L. 3D printed clotrimazole intravaginal ring for the treatment of recurrent vaginal candidiasis. Int. J. Pharm. 2021; 596: 120290. https://dx.doi.org/10.1016/j.ijpharm.2021.120290.
- Flint N.D., Rhoads J.L., Carlisle R., Ferrel M., Hopkins Z.H., Secrest A.M. The continued inappropriate use and overuse of combination topical clotrimazole-betamethasone. Dermatol. Online J. 2021; 27(8). https://dx.doi.org/10.5070/D327854686.
Received 20.09.2022
Accepted 22.09.2022
About the Authors
Inna A. Apolikhina, Dr. Med. Sci., Professor, Head of the Department of Aesthetic Gynecology and Rehabilitation, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia; Professor at the Department of Obstetrics, Gynecology, Perinatology, and Reproductology, Institute of Professional Education, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University), i_apolikhina@oparina4.ru, 117997, Russia, Moscow, Oparina str., 4.Marina O. Ramazanova, obstetrician-gynecologist, graduate student, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, mar1naramazanova@yandex.ru, 117997, Russia, Moscow, Oparina str., 4.
Authors' contributions: Apolikhina I.A. – content verification, manuscript approval for publication; Ramazanova M.O. – clinical material collection, review of publication on the topic of the article, data analysis and interpretation, writing the text of the manuscript.
Conflicts of interest: The authors declare that there are no conflicts of interest.
Funding: The article has been prepared without sponsorship.
Patient Consent for Publication: The patient provided informed consent for the publication of her data and associated images.
For citation: Apolikhina I.A., Ramazanova M.O.
Vulvovaginal candidiasis treatment with local clotrimazole.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2022; 9: 155-159 (in Russian)
https://dx.doi.org/10.18565/aig.2022.9.155-159
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