Abstract

Vulvovaginal candidosis is a common disease, and various treatment strategies have emerged over the last few decades. Clotrimazole belongs to the drugs of choice for the treatment of vulvovaginal candidosis. Although available for almost 50 years, systematic reviews on the usefulness of topical clotrimazole across disease severity and populations affected are scarce. Thus, we conducted a systematic literature search in the PubMed and Embase databases to summarize the effectiveness and safety of topical clotrimazole in the treatment of uncomplicated (acute) and complicated vulvovaginal candidosis. In total, 37 randomized controlled studies in women suffering from vaginal yeast infections qualified for inclusion in our review. In women with uncomplicated vulvovaginal candidosis, single intravaginal doses of clotrimazole 500 mg vaginal tablets provided high cure rates and were as effective as oral azoles. A single dose of clotrimazole 500 mg was equipotent to multiple doses of lower dose strengths. Prolonged treatment regimens proved to be effective in severe and recurrent cases as well as in symptomatic pregnant women. It is therefore expected that in the general population, clotrimazole will continue to be widely used in the field of vaginal health in the upcoming years; more so as clotrimazole resistance in vaginal candidosis is rare.

Highlights

  • Clotrimazole is an imidazole antimycotic agent that was discovered in the 1960s

  • Two additional studies conducted in men with Candida balanitis qualified for inclusion

  • 80–90% of symptomatic vulvovaginal candidosis cases are uncomplicated in nature [4]

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Summary

Introduction

Clotrimazole is an imidazole antimycotic agent that was discovered in the 1960s. It has a specific chemical structure consisting of four aromatic rings, out of which one represents an imidazole ring [1]. Clotrimazole has a broad antimicrobial activity against Candida albicans and other fungal species. Topical clotrimazole is widely used for the treatment of tinea pedis (athlete’s foot), cutaneous mycoses, and oropharyngeal candidosis [1,3]. It belongs to the drugs of choice for the topical treatment of vulvovaginal candidosis and Candida balanitis [4,5]

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