Experience with clotrimazole 2% cream in the therapy of vulvovaginal candidiasis: results of observational study
Objective. To present the results of using of various clotrimazole dosage forms (2%, cream and 100 mg vaginal tablets) and its dosage regimens (for 3 and 6 days) in patients with vulvovaginal candidiasis.Rakhmatulina M.R., Tarasenko E.N., Bolshenko N.V.
Subjects and methods. Examinations were made in 60 patients with vulvovaginal candidiasis, who were divided into 3 groups so that each group contained an equal number of people: 1) clotrimazole 2% cream as therapy for 3 days; 2) clotrimazole 2% cream for 6 days; 3) clotrimazole, 100 mg vaginal tablets for 6 days. The diagnosis was confirmed by the presence of Candida blastospores and pseudomycelium on microscopic examination and by the isolation of Candida albicans colonies on Sabouraud agar. The efficiency of therapy was evaluated after its completion, at 14 and 30 days.
Results. After completion of therapy, the clinical signs of vulvovaginal candidiasis were absent in 95% of the patients in Group 1, in 100% in Group 2, and in 80% in Group 3; those of Candida pseudomycelium and blastospores were also absent in 18 (90%), 20 (100%), and 15 (75%) patients, respectively. After treatment, elevated leukocyte counts in vaginal discharge persisted only in 2 (10%) patients in Group 3; there was a growth of yeast-like fungi in the patients of Groups 1 (10%) and 3 (20%). The therapy resulted in a significant decrease in the frequency of isolation of opportunistic microorganisms in clinically significant amounts and in the normalization of the vaginal microflora in 90% of the examinees.
Conclusion. The optimal profile of antimycotic and antimicrobial efficacy of clotrimazole 2% cream for intravaginal or topical use, which is superior to that when this agent is used as vaginal tablets, makes it possible to recommend it as one of the drugs of choice in the treatment of vulvovaginal candidiasis.
Keywords
vulvovaginal candidiasis
Candida albicans
non-albicans Candida
clotrimazole 2%
clotrimazole 100 mg
References
- Sherrard J., Wilson J., Donders G., Mendling W., Jensen J.S. 2018 European (IUSTI/WHO) International Union against sexually transmitted infections (IUSTI) World Health Organisation (WHO) guideline on the management of vaginal discharge. Int. J. STD & AIDS. 2018; 29(13): 1258-72. https://dx.doi:10.1177/0956462418785451.
- Mendling W., Schlegelmilch R. Three-day combination treatment for vulvovaginal candidosis with 200 mg clotrimazole vaginal suppositories and clotrimazole cream for the vulva is significantly better than treatment with vaginal suppositories alone – an earlier, multicentre, placebo-controlled double blind study. Geburtsh Frauenheilk. 2014; 74: 355-60. https://dx.doi:10.1055/s-0034-1368243.
- Workowski K.A., Bolan G.A.; Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm. Rep. 2015; 64(RR-03): 1-137.
- Canadian Guidelines on Sexually Transmitted Infections. 2016. Available at: https://www.canada.ca/en/public-health/services/infectious-diseases/sexual-health-sexually-transmitted-infections/canadian-guidelines.html
- Клинические рекомендации Российского общества дерматовенерологов и косметологов «Урогенитальный кандидоз». [Clinical guidelines of the Russian society of dermatovenerologists and cosmetologists “Urogenital candidiasis”. (in Russian)]. Available at: https://www.cnikvi.ru/docs/clinic_recs/klinicheskie-rekomendatsii-2019-2020/
- Клинические рекомендации по диагностике и лечению заболеваний, сопровождающихся патологическими выделениями из половых путей женщин. [Clinical guidelines for the diagnosis and treatment of diseases accompanied by abnormal discharge from the genital tract of women. (in Russian)]. Available at: http://kolpotest.ru/uploaded/rekomendacii_roag.pdf
- Рахматулина М.Р., Тарасенко Э.Н. Частота выявления грибов рода Candida у пациентов с урогенитальным кандидозом и анализ показателей их антимикотической резистентности за десятилетний период (2010–2020 гг.). Акушерство и гинекология. 2020; 7: 159-65. https://dx.doi.org/10.18565/aig.2020.7.159-165. [Rakhmatulina M.R., Tarasenko E.N. The detection rate of fungi of the Candida genus in patients with urogenital candidiasis and an analysis of the indicators of their antimycotic resistance over a ten-year period (2010–2020). Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2020; 7: 159-65. (in Russian)]https://dx.doi.org/10.18565/aig.2020.7.159-165
- 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.
- Greenbaum S., Greenbaum G., Moran-Gilad J., Weintruab A.Y. Ecological dynamics of the vaginal microbiome in relation to health and disease. Am. J. Obstet. Gynecol. 2019; 220(4): 324-35. https://dx.doi.org/10.1016/j.ajog.2018.11.1089.
- Santos C.M.A., Pires M.C.V., Leão T.L., Silva A.K.S., Miranda L.S., Martins F.S., Silva A.M., Nicoli J.R. Anti-inflammatory effect of two Lactobacillus strains during infection with Gardnerella vaginalis and Candida albicans in a HeLa cell culture model. Microbiology (Reading). 2018; 164(3): 349-58. https://dx.doi.org/10.1099/mic.0.000608.
- Ceccarani C., Foschi C., Parolin C., D‘Antuono A., Gaspari V., Consolandi C. et al. Diversity of vaginal microbiome and metabolome during genital infections. Sci. Rep. 2019 (9): 14095. https://dx.doi.org/10.1038 / s41598-019-50410-x.
- Cools P., Jespers V., Hardy L., Crucitti T., Delany-Moretlwe S., Mwaura M. et al. A multi-country cross-sectional study of vaginal carriage of Group B Streptococci (GBS) and Escherichia coli in resource-poor settings: prevalences and risk factors. PLoS One. 2016; 11(1): e0148052. https://dx,doi.org/10.1371/journal.pone.0148052.
Received 22.10.2020
Accepted 02.11.2020
About the Authors
Margarita R. Rakhmatulina, MD, professor, professor of the Department of dermatovenerology and cosmetology with a course of clinical laboratory diagnostics, A.I. Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency, Moscow, Russia.Tel.: +7(916) 203-10-03. E-mail: ra.marg@yandex.ru. ORCID: 0000-0003-3039-7769. 123098, Russia, Moscow, Zhivopisnaya str., 46.
Ellina N. Tarasenko, dermatovenerologist, Moscow Scientific and Practical Center of Dermatovenerology and Cosmetology of the Moscow Department of Health, Moscow, Russia. Tel.: +7(926)401-13-29. E-mail: ellina.tarasenko@mail.ru. ORCID: 0000-0001-8016-4109. 121170, Russia, Moscow, Kutuzovsky prospekt, 41.
Natalia V. Bolshenko, candidate of medical sciences, the head researcher of Central Research Institute of Epidemiology of the Federal Service on Customers’ Rights Protection and Human Well-being Surveillance, Moscow, Russia; Dermatovenerologist, Moscow Regional Clinical Dermatovenerological Center, Moscow, Russia. Тел.: +7(916)422-42-80. E-mail: sanabol@mail.ru. ORCID: 0000-0001-7257-5231.
111123, Russia, Moscow, Novogireevskaya str., 3a.; 129110, Russia, Moscow, Schepkina str., 61/2, build. 2.
For citation: Rakhmatulina M.R., Tarasenko E.N., Bolshenko N.V. Experience with clotrimazole 2% cream in the therapy of vulvovaginal candidiasis: results of an observational study. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2020; 11: 206-212 (in Russian).
https://dx.doi.org/10.18565/aig.2020.11.206-212
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