Review: oral and intravaginal agents are equally effective for treatment of uncomplicated vulvovaginal candidiasis
QUESTION: Are oral and intravaginal antifungal agents equally effective, safe, and cost effective for treatment of uncomplicated vulvovaginal candidiasis (thrush)?
Randomised controlled trials (RCTs) published in any language were identified by searching the Cochrane Controlled Trials Register (CENTRAL/CCTR), the Cochrane Collaboration Sexually Transmitted Disease Group Specialised Register of Controlled Trials, EMBASE/Excerpta Medica (1980 to January 2000), and Medline (January 1985 to May 2000). Reference lists of each trial were reviewed and UK manufacturers of antifungal agents were contacted.
Trials were selected if they included women ≥16 years of age with mycologically confirmed uncomplicated vulvovaginal candidiasis and they compared ≥1 oral antifungal agent with an intravaginal antifungal agent. Trials were excluded if they included only participants who were HIV positive, immunocompromised, pregnant, breast feeding, or diabetic.
Data were extracted on the type, dose, frequency, and duration of antifungal treatment; setting; participants; and outcome measures. Main outcomes were short and long term clinical cure rates. Secondary outcomes included mycological cure rates …