Topical treatment for vaginal candidiasis (thrush) in pregnancy.
BACKGROUND
Vaginal candidiasis (moniliasis or thrush) is a common and frequently distressing infection for many women. It is even more common in pregnancy. There is no evidence that thrush in pregnancy is harmful to the baby.


OBJECTIVE
The objective of this review was to assess the effects of different methods of treating vaginal candidiasis in pregnancy.


METHODS
We searched the Cochrane Pregnancy and Childbirth Group Trials Register. In addition, the Cochrane Controlled Trials Register (CENTRAL/CCTR) was searched. Date of last search: March 2001.


METHODS
Randomised trials of any treatment for vaginal candidiasis in pregnancy.


METHODS
Two reviewers assessed trial quality and extracted data.


RESULTS
Ten trials were included. Based on five trials, imidazole drugs were more effective than nystatin when treating vaginal candidiasis in pregnancy (odds ratio 0.21, 95% confidence interval 0.16 to 0.29). In turn, Nystatin was as effective as hydrargaphen in one trial (odds ratio 0.29, 95% confidence interval 0.05-1.84). A trial of clotrimazole was more effective than placebo (odds ratio 0.14, 95% confidence interval 0.06 to 0.31). Single dose treatment was no more or less effective than three or four days treatment. However, two trials involving 81 women, showed that treatment lasting for four days was less effective than treatment for seven days (odds ratio 11.7, 95% confidence interval 4.21 to 29.15). Based on two trials, treatment for seven days was no more or less effective than treatment for 14 days (odds ratio 0.41, 95% confidence interval 0.16 to 1.05). Terconazole was as effective as clotrimazole (odds ratio 1.41, 95% confidence interval 0.28- 7.10).


CONCLUSIONS
Topical imidazole appears to be more effective than nystatin for treating symptomatic vaginal candidiasis in pregnancy. Treatments for seven days may be necessary in pregnancy rather than the shorter courses more commonly used in non-pregnant women.
Young
G L
GL
Barn Croft Surgery, Temple Sowerby, Penrith, Cumbria, UK, CA10 1RZ. youngjckvg@compuserve.com
Jewell
D
D
D000287:Administration, Topical; D000935:Antifungal Agents / Q000627:therapeutic use*; D002181:Candidiasis, Vulvovaginal / Q000188:drug therapy*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic
D000935:Antifungal Agents