Comparing Oral Vs. Vaginal Antifungal Treatment for Vulvovaginal Candidiasis

Abstract

Background: Vulvovaginal candidiasis remains a pervasive gynecological concern, affecting a significant portion of women at least once in their lifetime. With the myriad of antifungal treatments available, the choice between oral and intravaginal therapies continues to challenge clinicians and patients alike, underscored by considerations of efficacy, side effects, and patient compliance. Objective: This study aimed to compare the efficacy, side effects, and acceptability of oral fluconazole and intravaginal clotrimazole for treating vulvovaginal candidiasis in a population of married women aged 16 to 50 years. Methods: Conducted as an interventional, experimental study at Pulse Medical Complex, Lahore, over six months from June 2023 to December 2023, 100 participants were randomly allocated to receive either a single dose of 150 mg oral fluconazole or 500 mg of clotrimazole administered as a vaginal pessary or 1% cream for three consecutive days. Data on demographic features, drug side effects, patient compliance, and cost-effectiveness were meticulously collected and analyzed using SPSS version 10.0. Results: Fluconazole demonstrated a higher cure rate with 84% of patients symptom-free within an average of 5 days, compared to 86% for clotrimazole over an average of 8.5 days. Side effects were more common and varied with fluconazole, yet 96% of patients expressed a preference for this treatment due to its convenience and faster symptom resolution. Clotrimazole users reported a 74% preference rate, primarily due to cost considerations. Conclusion: The study reaffirms the superior efficacy and patient acceptability of oral fluconazole over intravaginal clotrimazole for the treatment of uncomplicated vulvovaginal candidiasis, advocating for a patient-centered approach in the selection of antifungal therapy.