Effectiveness of prolonged use of fenticonazole in patients with chronic recurrent vulvovaginal candidiasis

Objective: To evaluate the effectiveness of a prolonged course of local therapy with fenticonazole for the prevention of recurrence of vulvovaginal candidiasis in patients with the chronic course of the disease.

Materials and methods: This was a prospective observational study which included 206 patients with recurrent vulvovaginal candidiasis; the patients were divided into two groups. The main group included 96 patients who received the local treatment as follows: fenticonazole 600 mg twice with an interval of 72 hours, then 600 mg once every 10 days for 3 months (subgroup 1, n=36); fenticonazole 600 mg twice with an interval of 72 hours once a month for 3 months (subgroup 2, n=30); fenticonazole 600 mg once every 10 days + 2 courses of platelet-rich plasma therapy (subgroup 3, n=30). The control group included 110 women who received induction therapy with fluconazole 150 mg orally on days 1, 4, 7, and then 150 mg once a week for 3 months. The patients of the groups matched for age, body mass index, somatic and gynecological diseases.

Results: There were no significant differences in the recurrence rate of candida vaginitis in patients who received systemic and topical therapy (p=0.66), but the recurrence rate was significantly higher in the control group during three-month follow-up (p=0.043). The effectiveness of therapy was 94.55% in the control group and there was no recurrence of the disease in 76.36% of patients over the next 3 months. The effectiveness of therapy was 92.71% in the main group and recurrence was not observed in 87.5% of patients.

Conclusion: Topical fenticonazole is effective in relieving and preventing recurrence of vulvovaginal candidiasis. The administration of an induction and prolonged course of fenticonazole may be an acceptable alternative to systemic therapy.