[Assessment of efficacy of ketoconazole/clindamycin vs metronidazole/nistatine in candidiasic vaginitis and bacterial vaginosis].
BACKGROUND
Term vaginitis refers to vaginal mucosa's inflammation, which produces a great variety of symptoms, including: abundant genital draining, of different color, fetid odor, pruritus, irritation, heat, dyspareunia, underwear spotting and frequently it is related to heat when urinating.


OBJECTIVE
To compare the ketoconazole/klindamycin vs metronidazole/nistatine efficacy for the treatment of vaginitis.


METHODS
Efficacy of the ketoconazole/klindamycin vs metronidazole/nistatine combination to treat Candida vaginitis and bacterial vaginosis by vaginal route was compared. Patients with diagnosis of vaginitis and bacterial vaginosis were included in a longitudinal, prospective, double-blind study. Patients were treated with ketoconazole/clindamycin vaginal tablets or metronidazole/ nistatine ovules for 6 days. Patients were evaluated at baseline and at day 7.


RESULTS
The global result showed that ketoconazole/clindamycin is superior to metronidazole/nistatine in the treatment of vaginitis/ vaginosis. C. albicans was isolated in 23 patients, 12 in the ketoconazole/clindamycin group and 11 in the metronidazole/nistatine group. At the end of the study, cultures were negative in 66.7% of ketoconazole/clindamycin group and in 54.5% of metronidazole/nistatine group. Eighteen cases presented mixed vaginitis, 13 in ketoconazole/clindamycin group and 5 in metronidazole/nistatine. At the end of the study, culture was negative in ketoconazole/clindamycin (83.3%) group and in all metronidazole/nistatine cases. Anaerobes were isolated in 21 patients, 9 in ketoconazole/clindamycin group and 12 in metronidazole/nistatine. At the end of the treatment, cultures were negative in 77% of ketoconazole/clindamycin group and in 66% of metronidazole/nistatine group; adverse reactions were not reported.


CONCLUSIONS
Treatment with ketoconazole/clindamycin for vaginitis/vaginosis is similar to that of metronidazole/nistatine. Microbiologically and clinically, treatment was well tolerated since there were not adverse reactions during the course of it.
Topete
Enrique Gómez Bravo
EG
Hospital de Ginecología y Obstetricia DIFEM, México.
Valencia
Miguel Garibay
MG
D000282:Administration, Intravaginal; D000293:Adolescent; D000328:Adult; D000368:Aged; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D002181:Candidiasis, Vulvovaginal / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome; D016585:Vaginosis, Bacterial / Q000175:diagnosis / Q000188:drug therapy*
D000890:Anti-Infective Agents