title: Usage of antifungal drugs for therapy of genital Candida infections, purchased as over-the-counter products or by prescription: I. Analyses of a unique database.
abstract: OBJECTIVE
  To present sales figures of antifungal drugs for treatment of genital Candida infections in females, which had been purchased in the Swedish county of Skåne (with approximately 1.2 million inhabitants) during the 1990s. To study the relative proportions of the drugs sold by prescription and as over-the-counter (OTC) products.
  
  
  METHODS
  Sales figures of antifungal drugs for therapy of vulvovaginal candidiasis (VVC) and such recurrent infections (RVVC), for the years 1990--99, were collected from the 'ACS' database of the National Corporation of Swedish Pharmacies.
  
  
  RESULTS
  The study showed an increase in sales of the type of drugs studied from 45,000 packages in 1990 until mid-93/94, when approximately 70,000 packages were sold (mainly azoles for topical use and fluconazole for oral intake). Thereafter there was a decrease until the end of November 1999, when 54,000 packages were purchased. Of the total sales, 93% were OTC products. Sales of clotrimazole and econazole (for vaginal installation) in 1993--1994 were equal to 85-90 packages/1000 women in the age group 15-45 years. Extremely high sales volumes of fluconazole and itraconazole, for one single year each, could be explained by marketing-related activities directed to the medical community.
  
  
  CONCLUSIONS
  As many women with RVVC are not cured by iatrogenic initiatives and women consider themselves able to diagnose episodes of genital Candida infection, affected women generally turn to self-medication with antifungal OTC products. This stresses the role of pharmacy counseling. Short-term marked alterations in sales volumes may be due to marketing factors rather than changes in the epidemiology of genital Candida infections.
authors.affiliation: Department of Obstetrics and Gynaecology, University Hospital, Lund, Sweden. per-anders.mardh@gyn.lu.se
authors.forename: Per-Anders
authors.initials: PA
authors.lastname: Mårdh
authors.forename: Jolanta
authors.initials: J
authors.lastname: Wågström
authors.forename: Maria
authors.initials: M
authors.lastname: Landgren
authors.forename: Jan
authors.initials: J
authors.lastname: Holmén
mesh_terms: D000293:Adolescent; D000328:Adult; D000935:Antifungal Agents / Q000008:administration & dosage*; D002181:Candidiasis, Vulvovaginal / Q000188:drug therapy* / Q000453:epidemiology; D003022:Clotrimazole / Q000008:administration & dosage; D019992:Databases as Topic; D011307:Drug Prescriptions; D004464:Econazole / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008825:Miconazole / Q000008:administration & dosage; D008875:Middle Aged; D004366:Nonprescription Drugs; D010594:Pharmacies; D012008:Recurrence; D012651:Self Medication; D013548:Sweden / Q000453:epidemiology
chemical_list: D000935:Antifungal Agents; D004366:Nonprescription Drugs; D004464:Econazole; D008825:Miconazole; D003022:Clotrimazole
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