Itraconazole vs fluconazole for the treatment of
uncomplicated acute vaginal and vulvovaginal candida in nonpregnant women: a metaanalysis
of randomized controlled trials.
Pitsouni E, Iavazzo C, Falagas ME.
Alfa Institute of Biomedical Sciences, Athens,
Greece.
In this metaanalysis of randomized controlled
trials (RCTs) we aimed to compare the in vivo
and in vitro activity and the safety of per os
itraconazole and fluconazole treatment of
uncomplicated acute vaginal/vulvovaginal candida in nonpregnant women. We used PubMed,
Scopus, Web of Science, and Cochrane Library to
identify the studies that were relevant to our
metaanalysis RCTs. Six RCTs were included in
this study that comprised 1092 enrolled patients
with signs and symptoms of vaginal/vulvovaginal candida that was confirmed by microscopy
and/or microbiologic cultures that were obtained
from the ectocervix and/or vaginal fundus.
Overall, there was no difference between
itraconazole and fluconazole regarding clinical
cure and improvement at the first and second
scheduled visit assessments (pooled odds ratio
[OR], 0.94 [95% CI, 0.6-1.48] and 1.09 [95% CI,
0.68-1.75], respectively), mycologic cure at the first and second scheduled visit assessments
(OR, 0.73 [95% CI, 0.31-1.7] and 0.71 [95% CI,
0.49-1.03], respectively), withdrawal of
patients because of severe adverse events (OR,
0.72 [95% CI, 0.16-3.32]), and adverse events
noted from the nervous and digestive systems
(OR, 1.07 [95% CI, 0.42-2.73] and 1.84 [95% CI,
0.3-11.27], respectively). In conclusion,
effectiveness and safety of oral itraconazole and fluconazole in the treatment of acute uncomplicated vaginal/vulvovaginal candida
are similar.
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