摘要:

The origin of vaginal candidosis infection is discussed and signs for detection described. Vaginal application of antifungal drugs is recommended in pregnancy to prevent transmission of candidosis to the newborn during delivery.

ISSN:1018-8843    

DOI:10.1159/000269981

出版商:S. Karger AG    

年代:1985

数据来源: Karger

摘要:

Terconazole is a triazole ketal with clinically useful antifungal activity. It is active against both Candida albicans and a range of dermatophytes. Animal and preliminary clinical studies have shown the drug to be non-toxic and virtually free from side-effects. It is a further addition to the range of effective drugs for the topical treatment of patients with vaginal candidosis and dermatophyte infection.

ISSN:1018-8843    

DOI:10.1159/000269982

出版商:S. Karger AG    

年代:1985

数据来源: Karger

摘要:

Terconazole, a new triazole ketal, is a broad-spectrum antifungal agent clinically effective against vaginal candidosis. Terconazole produces a larger zone of inhibition than clotrimazole and isoconazole when tested against Candida albicans in an agar inhibition disk diffusion study at 5 μg/disk and pH 7.3. When the three compounds were tested against C. albicans in Eagle’s Minimal Essential Medium (EMEM) containing fetal calf serum at pH 7.4, terconazole and clotrimazole were more potent than isoconazole. Terconazole exhibited fungicidal properties within only 2 days incubation with a minimum fungicidal concentration (MFC) of 32 μg/ml. In contrast, clotrimazole and isoconazole exhibited MFCs of 32 and 64 μg/ml, respectively, only after 7 days incubation. In EMEM containing defibrinated sheep blood at pH 7.4, terconazole also was fungicidal within 2 days’ incubation; clotrimazole but not isoconazole was fungicidal after 7 days incubation at 32 and 64 μg/ml. These data confirm that at or near a physiological pH terconazole has a more rapid onset of action than either clotrimazole or isoconazole against C. albicans. When tested at pH 6.3, terconazole, at concentrations up to 128 μg/ml, had no inhibitory effect on several species of Lactobacillus commonly found in normal vaginal flora. Under the same conditions tetracycline inhibited the growth of all these lactobacilli (MICs 0.5–8 μg/ml). These data suggest that in the treatment of vaginal candidosis, terconazole would exert a selective antifungal activity while allowing the recolonization of the beneficial l

ISSN:1018-8843    

DOI:10.1159/000269984

出版商:S. Karger AG    

年代:1985

数据来源: Karger

ISSN:1018-8843    

DOI:10.1159/000269935

出版商:S. Karger AG    

年代:1985

数据来源: Karger

ISSN:1018-8843    

DOI:10.1159/000269936

出版商:S. Karger AG    

年代:1985

数据来源: Karger

摘要:

Two studies of the absorption and excretion of terconazole were carried out in healthy women. In the first study, 38 women used terconazole cream either 0.2, 0.4, 0.8 or 2.0%, or placebo, administered vaginally daily for 7 days. Whole blood samples were taken at various intervals and the plasma terconazole concentrations measured using high performance liquid chromatography. Only administration of 0.8 and 2.0% cream achieved quantifiable plasma levels, the highest being 28.1 ng/ml (2.0% cream). Elimination half-life was between 2.6 and 8.6 h. In the second study, 24 women received suppositories containing either 80 or 240 mg terconazole, or placebo, which were inserted on 3 consecutive days. Plasma terconazole levels were measured by the same method. For the 80-mg dose, the range was 4.6–17.5 ng/ml and for 240 mg, 11.8–38.7 ng/ml. Elimination half-life was 8.9 h for 80 and 240 mg. Plasma terconazole levels in both studies decreased rapidly after reaching peak values. These studies suggest that there is only slight absorption of terconazole from the vaginal mucosa with cream or suppositories and that the small amount absorbed into the circulation is rapidly elimina

ISSN:1018-8843    

DOI:10.1159/000269985

出版商:S. Karger AG    

年代:1985

数据来源: Karger

ISSN:1018-8843    

DOI:10.1159/000269937

出版商:S. Karger AG    

年代:1985

数据来源: Karger

摘要:

Two groups each of 38 women with cultures positive for Candida on Sabouraud’s medium were studied. One group was given terconazole 0.8% cream for 5 days and the other clotrimazole 1% cream for 6 days. 1 week after treatment cultures from the whole terconazole group were negative for Candida, whereas one in the clotrimazole group was still positive and remained so after 4 weeks. Before treatment 27, 31, and 33 women in the terconazole groups, and 27, 33, and 35 subjects in the clotrimazole group suffered from pruritus, burning and discharge, respectively. 1 week after treatment pruritus and burning had subsided in all women in the terconazole group, but were still present in 3 and 5 patients, respectively, in the clotrimazole group. By that time 10 women on terconazole and 14 on clotrimazole still complained of vaginal discharge. 4 weeks after treatment 1 woman on clotrimazole suffered from pruritus and 2 subjects on terconazole from burning; discharge was still present in 9 patients on terconazole and in 8 on clotrimazole. Results of treatment after 1 week and 4 weeks were considered good to very good for all cases on terconazole and for 37 on clotrimazole; the results for 1 patient on clotrimazole were considered poor. 6 patients on clotrimazole reported burning following application of the cream. To increase the acceptability of antifungal treatment, those drugs with the fewest side-effects, such as burning or unpleasant odour, and which are easiest to apply should be prescribe

ISSN:1018-8843    

DOI:10.1159/000269986

出版商:S. Karger AG    

年代:1985

数据来源: Karger

ISSN:1018-8843    

DOI:10.1159/000269938

出版商:S. Karger AG    

年代:1985

数据来源: Karger

摘要:

The treatment duration in vaginal candidosis is still under discussion. Although a 3-day therapy with imidazoles is effective, many gynaecologists prescribe a 6-day therapy. Further, a recent double-blind study comparing 3 and 6 days’ treatments with econazole 150 mg demonstrated a lower relapse rate after 6 days’ therapy. It appeared to be necessary to develop a terconazole formulation adapted for this treatment duration. Our studies comparing various dosages demonstrated that 40 mg/day was adequate for a 6-day treatment. 102 patients with biologically proved vaginal candidosis were treated with this dosage. The mycological cure rate 1 week after treatment was 93%. Relapses occurred in only 12 % of the cured patients during the month following therapy. The product proved to be safe since only 2 patients experienced side-effects (burning/pruritus) not requiring discontinuation of the treatm

ISSN:1018-8843    

DOI:10.1159/000269987

出版商:S. Karger AG    

年代:1985

数据来源: Karger