Vaginal fenticonazole or vaginal clotrimazole for managing vaginal candidiasis: What should you choose?

Vaginal candidiasis is a common vaginal fungal infection. It is mainly caused by Candida albicans, which produce the symptoms and signs of vaginal candidiasis. The widespread use of antifungal drugs have shifted the causative agents of candida infections from C. albicans to other species.

The present study determined the prevalence of Candida species in OPD patients along with the pattern of sensitivity and antifungal resistance and compared the efficacy of a single dose of vaginal fenticonazole with a standard dose of clotrimazole.

The study randomized the patients into 2 groups, where Group A received single dose vaginal fenticonazole while group B received vaginal clotrimazole for six days.

The study found-

• Increased prevalence of Vaginal candidiasis in the age group of 21-30 years. 
• The most prevalent identified species among OPD patients was Candida glabrata.
• During follow-up, the fenticonazole group showed significant improvement in symptoms and satisfaction scores.
• Clinical improvement in signs of vaginal candidiasis, even with a positive wet mount smear on follow-up, was insignificant between the two groups.

Overall, it can be concluded that treatment with a single dose of fenticonazole is superior in terms of improvement in symptoms and satisfaction score than clotrimazole treatment. The resistance pattern of antifungal agents should be considered when tailoring the treatment plan.

Agarwal S, Thakkar N, Bhatt V. Comparison Of Efficacy Of Vaginal Fenticonazole Vs Vaginal Clotrimazole In Treatment Of Vaginal Candidiasis. Indian Obstetrics & Gynaecology.2023;13(3).