Treatment of complicated Candida vaginitis: Comparison of single and sequential doses of fluconazole
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,...
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Veröffentlicht in: | American journal of obstetrics and gynecology 2001-08, Vol.185 (2), p.363-369 |
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creator | 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. |
description | 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. (Am J Obstet Gynecol 2001;185:363-69.) |
doi_str_mv | 10.1067/mob.2001.115116 |
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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. (Am J Obstet Gynecol 2001;185:363-69.)</description><identifier>ISSN: 0002-9378</identifier><identifier>EISSN: 1097-6868</identifier><identifier>DOI: 10.1067/mob.2001.115116</identifier><identifier>PMID: 11518893</identifier><identifier>CODEN: AJOGAH</identifier><language>eng</language><publisher>Philadelphia, PA: Mosby, Inc</publisher><subject>Adult ; Antibiotics. Antiinfectious agents. Antiparasitic agents ; Antifungal agents ; Antifungal Agents - administration & dosage ; Antifungal Agents - adverse effects ; Antifungal Agents - therapeutic use ; Biological and medical sciences ; candida ; Candida - isolation & purification ; Candida albicans - isolation & purification ; Candidiasis, Vulvovaginal - drug therapy ; Candidiasis, Vulvovaginal - microbiology ; complicated ; Double-Blind Method ; Female ; fluconazole ; Fluconazole - administration & dosage ; Fluconazole - adverse effects ; Fluconazole - therapeutic use ; Humans ; Logistic Models ; Medical sciences ; Pharmacology. Drug treatments ; Prospective Studies ; Recurrence ; Vaginitis</subject><ispartof>American journal of obstetrics and gynecology, 2001-08, Vol.185 (2), p.363-369</ispartof><rights>2001 Mosby, Inc.</rights><rights>2001 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c440t-57ddf7ec27f0876ace6627e2538631fb7773f88c6e614aed72279d509aed33133</citedby><cites>FETCH-LOGICAL-c440t-57ddf7ec27f0876ace6627e2538631fb7773f88c6e614aed72279d509aed33133</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1067/mob.2001.115116$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>309,310,314,777,781,786,787,3537,23911,23912,25121,27905,27906,45976</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1132524$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11518893$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sobel, J.D.</creatorcontrib><creatorcontrib>Kapernick, P.S.</creatorcontrib><creatorcontrib>Zervos, M.</creatorcontrib><creatorcontrib>Reed, B.D.</creatorcontrib><creatorcontrib>Hooton, T.</creatorcontrib><creatorcontrib>Soper, D.</creatorcontrib><creatorcontrib>Nyirjesy, P.</creatorcontrib><creatorcontrib>Heine, M.W.</creatorcontrib><creatorcontrib>Willems, J.</creatorcontrib><creatorcontrib>Panzer, H.</creatorcontrib><creatorcontrib>Wittes, H.</creatorcontrib><title>Treatment of complicated Candida vaginitis: Comparison of single and sequential doses of fluconazole</title><title>American journal of obstetrics and gynecology</title><addtitle>Am J Obstet Gynecol</addtitle><description>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. (Am J Obstet Gynecol 2001;185:363-69.)</description><subject>Adult</subject><subject>Antibiotics. Antiinfectious agents. Antiparasitic agents</subject><subject>Antifungal agents</subject><subject>Antifungal Agents - administration & dosage</subject><subject>Antifungal Agents - adverse effects</subject><subject>Antifungal Agents - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>candida</subject><subject>Candida - isolation & purification</subject><subject>Candida albicans - isolation & purification</subject><subject>Candidiasis, Vulvovaginal - drug therapy</subject><subject>Candidiasis, Vulvovaginal - microbiology</subject><subject>complicated</subject><subject>Double-Blind Method</subject><subject>Female</subject><subject>fluconazole</subject><subject>Fluconazole - administration & dosage</subject><subject>Fluconazole - adverse effects</subject><subject>Fluconazole - therapeutic use</subject><subject>Humans</subject><subject>Logistic Models</subject><subject>Medical sciences</subject><subject>Pharmacology. Drug treatments</subject><subject>Prospective Studies</subject><subject>Recurrence</subject><subject>Vaginitis</subject><issn>0002-9378</issn><issn>1097-6868</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kDtPwzAQgC0EoqUws6EMrGn9SGyHDUW8pEosZY5c-1wZJXGxUyT49ThKJViY7k733enuQ-ia4CXBXKw6v11SjMmSkJIQfoLmBFci55LLUzTHGNO8YkLO0EWM72NJK3qOZiMtZcXmyGwCqKGDfsi8zbTv9q3TagCT1ao3zqjsU-1c7wYX77I6tVVw0fcjHF2_ayFLWBbh45BWONVmxkeIY9u2B-179e1buERnVrURro5xgd4eHzb1c75-fXqp79e5Lgo85KUwxgrQVFgsBVcaOKcCaMkkZ8RuhRDMSqk5cFIoMIJSUZkSVylnjDC2QKtprw4-xgC22QfXqfDVENyMvprkqxl9NZOvNHEzTewP2w7ML38UlIDbI6CiVq0Nqtcu_uEYLWmRsGrCIL336SA0UTvoNRgXQA-N8e7fG34AgN-HNA</recordid><startdate>20010801</startdate><enddate>20010801</enddate><creator>Sobel, J.D.</creator><creator>Kapernick, P.S.</creator><creator>Zervos, M.</creator><creator>Reed, B.D.</creator><creator>Hooton, T.</creator><creator>Soper, D.</creator><creator>Nyirjesy, P.</creator><creator>Heine, M.W.</creator><creator>Willems, J.</creator><creator>Panzer, H.</creator><creator>Wittes, H.</creator><general>Mosby, Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>20010801</creationdate><title>Treatment of complicated Candida vaginitis: Comparison of single and sequential doses of fluconazole</title><author>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.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c440t-57ddf7ec27f0876ace6627e2538631fb7773f88c6e614aed72279d509aed33133</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>Adult</topic><topic>Antibiotics. Antiinfectious agents. Antiparasitic agents</topic><topic>Antifungal agents</topic><topic>Antifungal Agents - administration & dosage</topic><topic>Antifungal Agents - adverse effects</topic><topic>Antifungal Agents - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>candida</topic><topic>Candida - isolation & purification</topic><topic>Candida albicans - isolation & purification</topic><topic>Candidiasis, Vulvovaginal - drug therapy</topic><topic>Candidiasis, Vulvovaginal - microbiology</topic><topic>complicated</topic><topic>Double-Blind Method</topic><topic>Female</topic><topic>fluconazole</topic><topic>Fluconazole - administration & dosage</topic><topic>Fluconazole - adverse effects</topic><topic>Fluconazole - therapeutic use</topic><topic>Humans</topic><topic>Logistic Models</topic><topic>Medical sciences</topic><topic>Pharmacology. Drug treatments</topic><topic>Prospective Studies</topic><topic>Recurrence</topic><topic>Vaginitis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sobel, J.D.</creatorcontrib><creatorcontrib>Kapernick, P.S.</creatorcontrib><creatorcontrib>Zervos, M.</creatorcontrib><creatorcontrib>Reed, B.D.</creatorcontrib><creatorcontrib>Hooton, T.</creatorcontrib><creatorcontrib>Soper, D.</creatorcontrib><creatorcontrib>Nyirjesy, P.</creatorcontrib><creatorcontrib>Heine, M.W.</creatorcontrib><creatorcontrib>Willems, J.</creatorcontrib><creatorcontrib>Panzer, H.</creatorcontrib><creatorcontrib>Wittes, H.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>American journal of obstetrics and gynecology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sobel, J.D.</au><au>Kapernick, P.S.</au><au>Zervos, M.</au><au>Reed, B.D.</au><au>Hooton, T.</au><au>Soper, D.</au><au>Nyirjesy, P.</au><au>Heine, M.W.</au><au>Willems, J.</au><au>Panzer, H.</au><au>Wittes, H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Treatment of complicated Candida vaginitis: Comparison of single and sequential doses of fluconazole</atitle><jtitle>American journal of obstetrics and gynecology</jtitle><addtitle>Am J Obstet Gynecol</addtitle><date>2001-08-01</date><risdate>2001</risdate><volume>185</volume><issue>2</issue><spage>363</spage><epage>369</epage><pages>363-369</pages><issn>0002-9378</issn><eissn>1097-6868</eissn><coden>AJOGAH</coden><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. (Am J Obstet Gynecol 2001;185:363-69.)</abstract><cop>Philadelphia, PA</cop><pub>Mosby, Inc</pub><pmid>11518893</pmid><doi>10.1067/mob.2001.115116</doi><tpages>7</tpages></addata></record> |
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subjects | Adult Antibiotics. Antiinfectious agents. Antiparasitic agents Antifungal agents Antifungal Agents - administration & dosage Antifungal Agents - adverse effects Antifungal Agents - therapeutic use Biological and medical sciences candida Candida - isolation & purification Candida albicans - isolation & purification Candidiasis, Vulvovaginal - drug therapy Candidiasis, Vulvovaginal - microbiology complicated Double-Blind Method Female fluconazole Fluconazole - administration & dosage Fluconazole - adverse effects Fluconazole - therapeutic use Humans Logistic Models Medical sciences Pharmacology. Drug treatments Prospective Studies Recurrence Vaginitis |
title | Treatment of complicated Candida vaginitis: Comparison of single and sequential doses of fluconazole |
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