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Monday 01 November 2004

[Assessment of efficacy of ketoconazole/clindamycin vs metronidazole/nistatine in candidiasic vaginitis and bacterial vaginosis]

By: Topete EG, Valencia MG.

Ginecol Obstet Mex 2004 Nov;72:575-80

BACKGROUND: Term vaginitis refers to vaginal mucosa's inflammation, which produces a great variety of symptoms, including: abundant genital draining, of different color, fetid odor, pruritus, irritation, heat, dyspareunia, underwear spotting and frequently it is related to heat when urinating. OBJECTIVE: To compare the ketoconazole/klindamycin vs metronidazole/nistatine efficacy for the treatment of vaginitis. MATERIAL AND METHODS: Efficacy of the ketoconazole/klindamycin vs metronidazole/nistatine combination to treat Candida vaginitis and bacterial vaginosis by vaginal route was compared. Patients with diagnosis of vaginitis and bacterial vaginosis were included in a longitudinal, prospective, double-blind study. Patients were treated with ketoconazole/clindamycin vaginal tablets or metronidazole/ nistatine ovules for 6 days. Patients were evaluated at baseline and at day 7. RESULTS: The global result showed that ketoconazole/clindamycin is superior to metronidazole/nistatine in the treatment of vaginitis/ vaginosis. C. albicans was isolated in 23 patients, 12 in the ketoconazole/clindamycin group and 11 in the metronidazole/nistatine group. At the end of the study, cultures were negative in 66.7% of ketoconazole/clindamycin group and in 54.5% of metronidazole/nistatine group. Eighteen cases presented mixed vaginitis, 13 in ketoconazole/clindamycin group and 5 in metronidazole/nistatine. At the end of the study, culture was negative in ketoconazole/clindamycin (83.3%) group and in all metronidazole/nistatine cases. Anaerobes were isolated in 21 patients, 9 in ketoconazole/clindamycin group and 12 in metronidazole/nistatine. At the end of the treatment, cultures were negative in 77% of ketoconazole/clindamycin group and in 66% of metronidazole/nistatine group; adverse reactions were not reported. CONCLUSION: Treatment with ketoconazole/clindamycin for vaginitis/vaginosis is similar to that of metronidazole/nistatine. Microbiologically and clinically, treatment was well tolerated since there were not adverse reactions during the course of it.

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