Clotrimazole Versus Amphotericin B In The Treatment Of Recurrent Vulvovaginal Candidiasis

Objective:To evaluate the safety and effectiveness of amphotericin B in the treatment of recurrent vulvovaginal candidiasis (RVVC).Methods:A total of 30 patients who were diagnosed as RVVC by clinic were randomly divided into two groups, Group A had 12 cases, Group B had 18 cases. Before the consolidation therapy, all patients were asked to carry out intensive treatment until the fungal culture was negative. Intensive treatment:clotrimazole 500mg was placed in vagina, three days later repeated. Three to seven days after drug withdrawal and periods before the menstruation, the vaginal discharge was checked and the fungi were cultured. If the result of culture was negative, we went to the consolidation therapy. If positive, we repeated the intensive treatment again after menstruation. If the fungal culture was positive again, the person would be removed from this study. Consolidation therapy: group A:amphotericin B vaginal effervescent tablets were placed in vagina 10mg×6 set days, once a month, continuing 3 months; group B:clotrimazole vaginal suppositories were placed in vagina 500mg×1 set day, twice a month, continuing 3 months. Three to seven days after drug withdrawal, all patients were asked to hospital for follow-up, simultaneously, the vaginal discharge was checked and the fungi were cultured, the improvement of signs and symptoms was recorded.Results:After intensive and consolidation treatment, the Clotrimazole group and the amphotericin B group had an analogous improvement of itching and discharge (P>0.05). There was no different in the pain and vaginal edema improvement, although the amphotericin B had a slight advantage (P>0.05). After 3 courses of consolidation therapy, all the people had remission of signs and symptoms, fungal cultures were both negative, there was no statistically differences in clinical effect (P>0.05).Conclusion:The treatment of RVVC should include intensive and consolidation therapy; there was no significant difference in cure rate, the same as the improvement of signs and symptoms. Amphotericin B shows good safety and efficacy in the treatment of RVVC, it can be another good choice for RVVC(?)...