Topical treatment for vaginal candidiasis in pregnancy.

BACKGROUND

Vaginal candidiasis (moniliasis or thrush) is a common and frequently distressing infection for many women. It is even more common in pregnancy.

OBJECTIVES

The objective of this review was to assess the effects of different methods of treating vaginal candidiasis in pregnancy.

SEARCH STRATEGY

We searched the Cochrane Pregnancy and Childbirth Group trials register. In addition, the Cochrane Controlled Trials Register (CENTRAL/CCTR) was searched. Date of last search: April 1999.

SELECTION CRITERIA

Randomised trials of any treatment for vaginal candidiasis in pregnancy.

DATA COLLECTION AND ANALYSIS

Two reviewers assessed trial quality and extracted data.

MAIN RESULTS

Twelve trials were included. Based on five trials, imidazole drugs were more effective than nystatin when treating vaginal candidiasis in pregnancy (odds ratio 0.21, 95% confidence interval 0.16 to 0.29). Nystatin,in turn was more effective than hydrargaphen in one trial.A trial of clotrimazole was more effective than placebo (odds ratio 0.14, 95% confidence interval 0.06 to 0.31). Single dose treatment was less effective than three or four days treatment when assessed by culture and by symptoms in three different trials and treatment lasting for four days was less effective than treatment for seven days (odds ratio 10.6, 95% confidence interval 4.01 to 28.05). Based on two trials, treatment for seven days was no more or less effective than treatment for 14 days (odds ratio 0.41, 95% confidence interval 0.16 to 1.05).

REVIEWER'S CONCLUSIONS: Topical imidazole appears to be more effective than nystatin for treating symptomatic vaginal candidiasis in pregnancy. Treatments for seven days may be necessary.