Weekly Drug Reduces Vaginal Yeast Infections

Long-Term Treatment With Diflucan Reduces Rate of Recurrent Infections

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Dec. 9, 2004 -- A weekly dose of an antifungal medication can tame recurrent vaginal yeast infections, according to a study in The New England Journal of Medicine.

The vaginal yeast infection called vulvovaginal candidasis isn't life threatening, but it can be an uncomfortable, even painful, nuisance that women would rather not talk about. Recurrent vaginal candida infections strike about 5% to 8% of women. The condition is not sexually transmitted, and the majority of patients have no recognizable risk factors.

Finding a safe and effective therapy to keep symptoms at bay has proved challenging. Nearly 20 years ago, doctors prescribed daily doses of the antifungal ketoconazole for prevention of recurrent vaginal yeast infections. Although effective, ketoconazole can cause serious side effects, including jaundice. Weekly doses of Diflucan, a newer antifungal, appear to be well tolerated and effective in preventing recurrent vaginal yeast infections.

For the new study, Jack Sobel, MD, a professor of internal medicine and chief of infectious diseases at Wayne State University School of Medicine, and colleagues evaluated the effectiveness of weekly oral Diflucan therapy in women with a history of recurrent vaginal yeast infections.

The researchers assigned 387 women to receive either Diflucan or a placebo weekly for six months. The treatment was followed by six months of observation without therapy.

Ninety percent of the patients who received Diflucan remained free of yeast infections during the first six-month period, compared with about 36% of those who took a placebo.

Nine months after the start of the study 73% of the women who took Diflucan remained free of yeast infections, compared with about 28% of the women not taking the antifungal.

At one year, about twice as many women taking Diflucan were still free of infection compared with those on the placebo.

"Long-term weekly treatment with [Diflucan] can reduce the rate of recurrence of symptomatic vulvovaginal candidasis. However a long-term cure remains difficult to achieve," the researchers write in the journal.

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SOURCE: Sobel et al. The New England Journal of Medicine, Aug. 26, 2004; vol 351: pp 876-883.
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