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Cited by 158Antifungal resistance and susceptibilityReproductive tract infections researchOcular Infections and Treatments

Treatment of complicated Candida vaginitis: Comparison of single and sequential doses of fluconazole

Sobel, J.D., Kapernick, P.S., Zervos, M., Reed, B.D., Hooton, T., Soper, D., Nyirjesy, P., Heine, M.W. +3 more·2001·American Journal of Obstetrics and Gynecology
DOI 10.1067/mob.2001.115116
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Abstract

Objective An attempt was made to validate recent recommendations that women with complicated Candida vaginitis (severe or recurrent, non-albicans Candida spp or abnormal host) require longer-duration antifungal therapy to achieve clinical cure and mycologic eradication.Study design A prospective, multicenter, randomized, double-blind study was performed comparing a single dose of 150 mg of fluconazole with 2 sequential 150-mg doses of fluconazole given 3 days apart.Results Five hundred fifty-six women with severe or recurrent Candida vaginitis were enrolled, and 398 had at least one postbaseline evaluation (intent to treat) and of these 309 were fully evaluable (efficacy-valid). At baseline, 92% of vaginal isolates were Candida albicans. The 2-dose fluconazole regimen achieved significantly higher clinical cure rates in women with severe vaginitis when evaluated on day 14 (P =.015) and higher clinical and mycologic responses persisted at day 35. Women with recurrent but not severe vaginitis did not benefit clinically short term by the additional fluconazole dose. Multivariate logistic regression analysis showed that being infected with non-albicans Candida predicted significantly reduced clinical and mycologic response regardless of duration of therapy. Fluconazole therapy was well tolerated and free of serious adverse effects.Conclusion Treatment of Candida vaginitis requires individualization, and women with severe Candida vaginitis achieve superior clinical and mycologic eradication with a 2-dose fluconazole regimen.

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Crossref · 10.1067/mob.2001.115116

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  • Complicated vaginitis is seen in approximately 10% of patients and requires antimycotic therapy for at least 7 days, either daily topical therapy or two 150-mg doses of fluconazole 72 h apart.

    “In contrast, the complicated vaginitis seen in ∼10% of patients requires antimycotic therapy for у7 days, either daily as topical therapy or as two 150-mg doses of fluconazole administered 72 h apart [314] (A-I).”

    From Guidelines for Treatment of Candidiasis (2004) · cites this paper as [314]

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Authors
Sobel, J. D., Kapernick, P. S., Zervos, M., Reed, B. D., Hooton, T., Soper, D., Nyirjesy, P., Heine, M. W., Willems, J., Panzer, H., & Wittes, H.
Affiliations
  • Wayne State University (US)
  • University of Arizona (US)
ORCID
Venue
American Journal of Obstetrics and Gynecology
Publisher
Elsevier BV
Published
2001-08
Volume
185
Issue
2
Pages
363-369
ISSN
0002-9378 (ISSN-L)
DOI
10.1067/mob.2001.115116
OpenAlex
W1999876505
Cited by
158
References
13
Citations by year
2026: 1 · 2025: 2 · 2024: 3 · 2023: 6 · 2022: 6 · 2021: 9 · 2020: 6 · 2019: 5 · 2018: 1 · 2017: 9 · 2016: 10 · 2015: 10 · 2014: 7 · 2013: 4 · 2012: 7
FWCI
6.56
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • American Journal of Obstetrics and Gynecology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
  • Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
  • Health Sciences › Medicine › Ophthalmology › Ocular Infections and Treatments
Keywords
Candida vaginitis, fluconazole, single-dose therapy, sequential dosing, antifungal therapy duration, recurrent vaginitis, non-albicans Candida, Candida albicans, clinical cure, vaginal candidiasis
MeSH terms
Adult, Antifungal Agents, Candida, Candida albicans, Candidiasis, Vulvovaginal, Double-Blind Method, Female, Humans, Prospective Studies, Recurrence, Fluconazole, Logistic Models

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