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Oral versus intra‐vaginal imidazole and triazole anti‐fungal agents for the treatment of uncomplicated vulvovaginal candidiasis (thrush): a systematic review
Author(s) -
Watson Margaret C.,
Grimshaw Jeremy M.,
Bond Christine M.,
Mollison Jill,
Ludbrook Anne
Publication year - 2002
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.2002.01142.x
Subject(s) - medicine , thrush , cochrane library , clinical trial , medline , systematic review , randomized controlled trial , gynecology , cervical cancer , cancer , human papilloma virus , political science , law
Objectives To compare the relative effectiveness, cost effectiveness and safety of oral versus intra‐vaginal anti‐fungal treatments for uncomplicated vulvovaginal candidiasis (thrush) and establish patient preference for the route of anti‐fungal administration Design A systematic review of studies comparing oral and intra‐vaginal anti‐fungal treatments for uncomplicated vulvovaginal candidiasis. Standard Cochrane Collaboration methods were used Data sources The following sources were searched: the Cochrane Controlled Trials Register; the Cochrane Sexually Transmitted Disease review group Specialised Register of Controlled Trials; EMBASE (January 1980 to January 2000); and MEDLINE (January 1985 to May 2000). The reference list of each trial was checked for additional references. The manufacturers of anti‐fungal treatments in the UK were asked for information on trials fulfilling the inclusion criteria Methods There was duplicate, independent examination and selection of the electronic search results followed by duplicate data abstraction. Disagreements regarding inclusion status and data abstraction were resolved by discussion between reviewers and the editor of the Cochrane Sexually Transmitted Disease group. Randomised controlled trials conducted worldwide and published in any language were included. The primary outcome measure was clinical cure. Mycological cure, patient preference and safety were secondary outcome measures Results Seventeen trials were included in the review, reporting 19 oral versus intra‐vaginal anti‐fungal treatment comparisons. No statistically significant differences were shown between oral and intra‐vaginal anti‐fungal treatment for clinical or mycological cure. All 10 trials that reported a preference favoured oral treatment (compared with intra‐vaginal or no preference). No trials presented cost data Conclusions There is no difference between the relative effectiveness of oral and intra‐vaginal anti‐fungal treatment for thrush