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Back to Infectious Disease Articles

Friday, 27 August 2004

Diflucan, taken once a week for six months was found to reduce the frequency of recurrent vaginal Candida infections by more than 90%.

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  Vaginal candidiasis
Diflucan info

In a study published in this weeks issue of New England Journal of Medicine, researchers have found long term administration of Diflucan to be effective in treating chronic vaginal candidiasis.

Vaginal yeast infection (vaginal candidiasis) is a common condition which almost every woman has experienced at one time or another. It is usually very easy to treat. However, for some less fortunate ones (almost 5%) the infection keeps recurring. Those with four or more infections per year are termed as having chronic/  recurrent vaginal candidiasis.

It is not known why some women experience recurrent infections. Chronic vulvovaginal candidiasis is term denoting more than four episodes a year. Several theories exist as to why this happens in some women. One theory proposes that re-infection of the vagina occurs from an intestinal reservoir, another theory assumes that small numbers of the organism remain in the vagina. The sexual transmission theory views an untreated partner as the source of the reinfection.

In patients with recurrent candidiasis, treatment consisted of therapy based on a positive fungal culture, corroborated by a negative follow-up culture. This results in resolution of symptoms approximately 90 percent of the time.

Diflucan (fluconazole)

Diflucan (fluconazole) is a potent antifungal known to act against most candida species (particularly candida albicans). Diflucan, manufactured by Pfizer Pharmaceuticals, has demonstrated effective action against both oral and vaginal candidiasis even in cases resistant to nystatin or clotrimazole. One of it's side effects is liver toxicity although that appears to be more common in patients with concomitant health issues and seems to be reversible on stopping the drug.

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Study details

In a six-month placebo controlled study involving nearly 400 women with a history of recurrent candida vaginal infections, the antifungal drug Diflucan, taken once a week, was found to reduce the frequency of infections by more than 90%.

Long term use of the drug appeared to be safe and highly effective in preventing recurrent vaginal yeast infections. The women treated with Diflucan initially took three 150-milligram oral doses of the drug at 3 day intervals, followed by a weekly 150-milligram dose taken for six months.

By the end of the six-month treatment period just 8% of the women on Diflucan had experienced recurrences, compared with 64% of women in the control group. Six months after treatment ended, however, 57% of the women treated with Diflucan had experienced recurrences, leaving 43% of the Diflucan-treated women with no vaginal infections in the six months after treatment ended.


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


Dr. Tamer Fouad, M.D.


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