Three-day treatment of vulvovaginal candidiasis

N-Methylfulleropyrrolidine-Based Multimode Sensor for Determination of Butoconazole Nitrate

A multimode sensor (a sensor responding simultaneously to more than one mode, e.g., stochastic mode, amperometric mode, voltammetric mode) based on graphite paste modified with N-methylfulleropyrrolidine was proposed for the determination of butoconazole nitrate in its pharmaceutical formulation. The stochastic mode and square wave voltammetry mode were applied for the determinations. Both the stochastic mode and square wave voltammetry mode were applied for a qualitative and quantitative assay of butoconazole nitrate. The sensor can be used between 1.68 × 10^-6 and 1.68 × 10⁴ μmol L^-1 when the stochastic mode is used and between 0.168 and 16.80 μmol L^-1 when the square wave voltammetry mode is used. The multimode sensor was reliably used for the determination of butoconazole nitrate in its pharmaceutical formulation, Gynofort cream, the recorded recoveries being higher than 99.00%, with RSD (%) values of lower than 2.00%.

Semisynthetic derivatives of purpuromycin as potential topical agents for vaginal infections

Purpuromycin (1) is an antibiotic with a broad spectrum of antimicrobial activity, encompassing bacteria, fungi, and protozoa, particularly those involved in vaginal infections. With the aim of enhancing the solubility and reducing the serum binding, a chemical program of modifications was undertaken on the natural compound, and a new interesting series of derivatives at the naphthoquinone system was synthesized and evaluated as potential topical agents for vaginal infections. In particular three semisynthetic derivatives, 7'-amino (8a), 7'-methylamino (8b), 7'-ethylamino (8c), of 7'-demethoxypurpuromycin seemed to be the most promising. They were tested for in vitro activity against three of the most important vaginal pathogens and showed activity similar to that of purpuromycin against Candida isolates while they were significantly more active against Trichomonas vaginalis and Gardnerella vaginalis, which are cultured in media containing blood or serum. This is probably due to the fact that the activity of the derivatives is less antagonized by these supplements than that of purpuromycin.

Vaginal infections in adult women

Often trivialized by the medical profession, vaginitis in adult women is not only extremely common but is the source of considerable distress and often results in marked suffering. Epidemiologic studies described in this article indicate the high prevalence of vaginitis and the large number of causes. Although the majority of infections in women are due to bacterial vaginosis, VVC, and trichomoniasis, it is clear that many other causes exist, and we have yet to discover the etiology of many clinical syndromes. Considerable progress has been made in understanding the pathogenesis of the three common vaginitides. Although excellent progress has been made by the pharmaceutical industry in providing new drugs for vaginitis, any further progress will require a better understanding of etiology and pathogenesis. Vaginitis causes major symptoms and is more than a nuisance problem. Clinicians owe it to their patients to attempt to make an accurate diagnosis and not to rely on empiric therapy.

Individualizing treatment of vaginal candidiasis

Clinicians have a vast array of effective antimycotics for the treatment of vaginal candidiasis. Multiple topical formulations are available, yet there is little evidence to suggest that formulation per se influences outcome. A growing number of highly effective oral systemic antimycotic agents provide the practitioner with additional options. Treatment regimens have also changed with the introduction of shorter, often single-day/single-dose courses of therapy. Not all therapeutic agents have the same activity against vaginal fungal pathogens in that topical azoles tend to be more active than nystatin. Differences in patient characteristics, however, are more important than the differences between antimycotic agents and therapeutic regimens in determining selection of the appropriate antimycotic. Patients with vaginal candidiasis vary with regard to duration and severity of symptoms and past frequency of attacks, distribution of inflammation, and pregnancy status. The clinician should consider all these variables both in selecting the appropriate antimycotic agent and the route of administration and in planning the duration of therapy. Individualized therapy offers additional benefits to patients, who may then enjoy the maximum advantages of antimycotics now available.

Single dose therapy of vaginal candidiasis: a comparative trial of fenticonazole vaginal ovules versus clotrimazole vaginal tablets

An open, randomized comparative clinical trial was performed in 153 patients suffering from symptomatic vaginal candidiasis confirmed by mycological tests. Patients were allocated at random into two groups: the first group (consisting of 75 subjects) was treated with a single vaginal ovule of fenticonazole (600 mg) and the second group (consisting of 78 subjects) was treated with a single vaginal tablet of clotrimazole (500 mg). Therapeutic efficacy was assessed by microbiological and clinical criteria 7 days and 1 month (when possible) after the single dose treatment. At the first follow-up visit, complete disappearance of the signs and symptoms or a highly significant reduction of their intensity was observed in both treatment groups. No significant difference was evident between the two drugs. At 7 days, the mycological tests gave negative results in 92% of the patients in the fenticonazole group and in 88.5% of the patients in the clotrimazole group. The difference between the two treatment groups was again not statistically significant. The second follow-up visit was performed in 55 (73.3%) patients of the fenticonazole group and in 52 (66.7%) patients of the clotrimazole group. The results indicate that 83.6% of patients in the fenticonazole group and 69.2% of patients in the clotrimazole group were still disease free at the time of this visit. Both drugs were well tolerated. Mild, local and short lasting side-effects were reported in only 5 cases of the group treated with fenticonazole.(ABSTRACT TRUNCATED AT 250 WORDS)

Vulvovaginal candidosis: comparison of 3-day treatment with 2% butoconazole nitrate cream and 6-day treatment with 1% clotrimazole cream

Sixty-three women with laboratory confirmed diagnoses of vulvovaginal candidosis were enrolled into this randomized, single-blind, parallel comparison of treatment with 2% butoconazole nitrate cream for 3 days and 1% clotrimazole cream for 6 days. Approximately 1 week after treatment ended both medications had substantially relieved vulvovaginal discharge, itching, burning, erythema and swelling. Both fungal cultures and potassium hydroxide stained preparations of vaginal secretions were negative for 93.3% of the butoconazole nitrate-treated patients. Comparable results for clotrimazole-treated patients were 80.6% and 77.4%, respectively. Both treatments improved the clinical signs and symptoms of candidosis. More butoconazole nitrate-treated patients (53.3%) had a 'very good' clinical response to treatment than clotrimazole-treated patients (38.7%). None of these differences was statistically significant, nor were statistically significant differences found between the percentages of patients considered clinically, microbiologically, or therapeutically cured in each group. No adverse experiences were associated with either treatment. Thus, the 3-day butoconazole nitrate regimen was considered as efficacious and safe as the 6-day clotrimazole regimen.