Efficacy Of Oral Fluconazole Research Articles

Meta analysis of clinical efficacy of fluconazole combined with clotrimazole in the treatment of candida vaginitis

Objective To explore the clinical efficacy of oral fluconazole combined with clotrimazole vaginal administration in the treatment of candida vaginitis by meta analysis. Methods Fluconazole combined with clotrimazole was selected as experiment group and clotrimazole alone was selected as control group. The randomized controlled trials(RCTs) were retrieved from PubMed, Cochrane library, Embase, China Notional Knowledge infrastructure(CNKI), WangFang and VIP database and references listed in all studies. RCTs meeting inclusive studies were included, the data were extracted, the quality was evaluated and cross-checked by two reviews independently according to Cochrane Handbook for Systematic Reviews of Interventions and then Meta-analysis was conducted using Stata14.0 software. Results A total of 15 studies and 1 792 patients were included.The experiment group had a higher overall efficiency(experiment group in 96.13% and control group in 83.8%), the difference was statistically significant (RR=1.13, 95%CI 1.08~1.18, P<0.001). The recurrence rate after treatment(experiment group in 6.46% and control group in 20.74%) had statistically significant difference between the two groups (RR=0.31, 95%CI 0.21~0.46, P<0.001). Conclusion Meta analysis showed that oral fluconazole combined with clotrimazole vaginal administration has a better clinical efficacy. Key words: Candidiasis, vulvovaginal; Randomized controlled trial; Meta-analysis; Fluconazole; Clotrimazole; Effective rate; Relapse rate

Efficacy of Oral Fluconazole in the Treatment of Seborrheic Dermatitis

Seborrheic dermatitis (SD) is a common, chronic dermatosis. Although the pathogenetic mechanisms of SD are not clear, Malassezia spp. yeasts are known to cause the disease. Previous studies have shown that topical and systemic antifungals provide clinical benefit. To evaluate the safety and efficacy of short-term oral fluconazole in patients with SD. Sixty-three patients with mild-to-moderate SD were randomly allocated to receive either oral fluconazole 300 mg in a single dose per week or placebo, for 2 weeks. Twenty-seven patients taking fluconazole and 23 patients taking placebo completed the study and were analyzed. The SD area severity index (SDASI) score and the patient's subjective assessment of pruritus and burning sensation were evaluated before and after treatment. Both the investigator and the patients were blinded to treatment. A statistically significant improvement in SDASI score after treatment compared with baseline was obtained with fluconazole (p=0.01) but not with placebo. However, the difference between the treatment groups was not statistically significant (p>0.05). Subjective improvements in symptoms, such as pruritus and burning sensation, were observed in both groups but no statistically significant differences versus baseline were seen. The results of this study indicate that fluconazole provides marginal and statistically insignificant benefit for the therapy of SD. However, larger studies using different dosages and/or durations of fluconazole therapy may provide a rationale for systemic use of fluconazole in SD.

A double-blind comparison of fluconazole and nystatin in the prevention of candidiasis in patients with leukaemia

In this multicentre, randomised, double-blind study, the safety and efficacy of oral fluconazole (200μg/day) and nystatin suspension (6000000IU/day) for the prevention of fungal infections were compared in patients with leukaemia undergoing remission induction chemotherapy. Antifungal prophylaxis was initiated at the time chemotherapy was started and continued throughout the hospital stay or the period of neutropenia to a maximum of 42 days. Prophylaxis was successful (no evidence of fungal infection or fever of unknown origin unresponsive to antibiotics) in 38 of 56 (68%) fluconazole-treated and 25 of 53 (47%) nystatin-treated patients (P=0.03). 2 patients (4%) in the fluconazole group and 6 (11%) patients in the nystatin group developed systemic fungal infections (P=0.15). The overall frequency of adverse events was similar among fluconazole-treated (29%) and nystatin-treated (32%); most events in both treatment groups involved the gastrointestinal tract. These results indicated fluconazole was more effective than nystatin in preventing Candida infections in patients with leukaemia; fluconazole was well tolerated.

Fluconazole versus nystatin in the treatment of oral candidosis

The efficacy of oral fluconazole versus nystatin was evaluated as a treatment modality for oral candidosis. Of the included patients (n = 60), two-thirds presented with an erythematous candidosis, and the others showed clinical signs compatible with a pseudomembranous candidosis. Predisposing factors were xerostomia (n = 18), HIV (n = 5), immunosuppression in conjunction with organ transplantation (n = 10), and wearing of dentures (n = 14). For the remaining patients no specific predisposing factors were found. One patient who was treated with nystatin was excluded owing to nausea that was related to the antifungal treatment. After 7 days of treatment with fluconazole (50 mg/day), the affected oral mucosa, assessed by the investigator, was cured or showed considerable improvement in 87% of the patients (n = 30). The corresponding figure for the nystatin group (n = 30), rinsing with 1 mL 4 times a day for 21 days, was 80%. Following treatment with fluconazole, 20 of 22 patients with symptoms at the start (91%) reported improvement. The comparable figures for the nystatin group were 10 of 12 patients (83%). Half of the patients in the nystatin group reported inconvenience from taking the medication (mean value = 25.9) compared with 23% of the patients in the fluconazole group (mean value = 6.6). Eight patients in the fluconazole group and 12 patients in the nystatin group exhibited a relapse within 6 months. These differences were not found to be statistically significant. The patients in the fluconazole group reported less inconvenience from taking the medication, a finding that may have clinical implications for compliance.

Fluconazole versus Amphotericin B in the Treatment of Esophageal Candidiasis in Cancer Patients

Thirty-one patients with malignancy and endoscopy-confirmed symptomatic esophageal candidiasis were randomly assigned to receive oral fluconazole, 200 mg once daily, or intravenous amphotericin B, 0.3 mg/kg, over 1-4 weeks. Clinical efficacy was determined weekly and follow-up esophageal endoscopy with biopsy and culture performed whenever possible. Both agents produced rapid resolution of symptoms, especially dysphagia and odynophagia. All 13 evaluable patients in the fluconazole group and 10/12 treated with amphotericin had clinical improvement. Endoscopy showed eradication of the fungus in all 11 patients undergoing repeat endoscopy, with cure or improvement of esophagitis. The incidence of adverse effects attributable to treatment was higher in the amphotericin group. The efficacy of oral fluconazole in esophageal candidiasis appears to be equivalent to that of amphotericin, with fewer adverse reactions.

Efficacy of oral fluconazole in the treatment of AIDS associated oesophageal candidiasis

To assess the efficacy and tolerance of fluconazole in the treatment of oesophageal candidiasis, 47 AIDS patients with this infection were enrolled in an open prospective study using fluconazole 100 mg given orally once daily. Clinical cure was obtained in all of 41 evaluable patients, with confirmation of cure in all of 31 patients who underwent post-treatment oesophagoscopy. Forty patients were followed up for at least 30 days; none suffered a relapse of oesophagitis but seven had a recurrence of stomatitis which was effectively treated with fluconazole. Fluconazole was well tolerated. Nausea was noted in three patients one of whom interrupted therapy. Transient mild elevation of ALT/AST was noted in five of 41 patients (12%). Fluconazole appears to be a safe and effective agent for oral therapy of oesophageal candidiasis associated with AIDS.