Treatment of severe vulvovaginal candidiasis and the comparative study of the mycological efficacy of miconazole nitrate and fluconazole

Objective To determine the clinical manifestations of severe VVC and to study the mycological efficacy of miconazole nitrate 1200 mg vaginal ovule with fluconazole 150mg for severe VVC.Methods According to Sobel classify,a prospective randomized and comparative study were conducted among 245 patients with severe VVC.123 patients received miconazole nitrate 1200 mg vaginal ovule before sleeping and another 1200mg after 72 hours,and 140 patients received oral fluconazole 150mg and another 150mg after 72 hours.Mycological efficacy assessments were carried out at days 7 to 14 and days 30 to 35 after treatment.Results The mycological cure rates at days 7 to 14 after treatment were respectively 90.27%(102/113)and 87.72%(100/114)in patients receiving miconazole nitrate and fluconzaole(P0.05).The mycological cure rates at days 30 to 35 after treatment were respectively 76.11%(86/113)and 70.18%(80/114)in patients receiving miconazole nitrate and fluconzaole(P0.05).Candida albicans were isolated most frequently(228/245,93.06%) in severe VVC.The side effect rate of miconazole nitrate was 1.63%(2/123),and side effect was not found in the fluconazole group(P0.05).Conclusions The treatment of miconazole nitrate 1200mg vaginal ovule twice in severe VVC is effective and safty.Candida albicans were the primary pathogeny of severe VVC.