Itraconazole in the treatment of acute and recurrent vulvovaginal candidosis: comparison of a 1-day and a 3-day regimen

Itraconazole is a systemic triazole with a broad-spectrum antifungal effect which belongs to a standard choice for the treatment of vulvovaginal candidosis. Thirty-four patients with acute and 26 patients with recurrent form of culture documented attacks of vulvovaginal candidosis were evaluated. There was frequent discrepancy between severe symptoms and weaker signs in patients with recurrent form than in the group with acute sporadic form. Eighteen patients with the acute form and 13 patients with the recurrent form of vulvovaginal candidosis received 1-day therapy (twice 200 mg of itraconazole in 1 day). Sixteen patients with the acute form and 13 patients with the recurrent form received 3-day therapy (200 mg of itraconazole daily for three following days). The cure rates 1 month after treatment were 97.1 and 76.9% in patients with the acute sporadic and recurrent form of vulvovaginal candidosis, respectively. Positive cultures in the latter group documented relapses. These clinical failures were not related to the resistance of yeasts to itraconazole. With the exception of one case of alopecia areata, side effects were minimal. The application of the long-term regimens and suppressive therapy with azole drugs is suggested in patients with recurrent vulvovaginal candidosis.