povidone-iodine and Candidiasis--Vulvovaginal

This randomised, double-blind, multicentric clinical study compared the efficacy and tolerability of the two vaginal antiseptics, 10 mg dequalinium chloride (CAS 522-51-0, Fluomycin N) and 200 mg povidone iodine (CAS 25655-41-8), in a parallel-group design. A total of 180 patients with vaginal infections of varying etiology participated in this study (bacterial vaginosis, fluor vaginalis, vulvo-vaginal candidiasis, trichomoniasis). Patients were randomly allocated to one of the two treatment groups and were treated once per day for 6 days. Control examinations took place 5 to 7 days after the end of treatment, and 3 to 4 weeks after the first control examination. The total symptoms score, a summary score for the clinical symptoms, discharge, burning, pruritus, redness of vulva/vagina, was defined as primary efficacy parameter. The treatments at the first control examination were compared in the full analysis set using the Wilcoxon-Mann-Whitney U-test, 2-sided, thereby proving equivalence of both treatments at the 5% level. Both treatments strongly improved the symptoms of vaginal infections both on short-term and long-term follow-up. Descriptive analysis of the secondary parameters, vaginal pH, degree of purity of the vaginal flora, and number of lactobacilli in the wet mounts, supported the comparable efficacy of both therapies to restore the vaginal milieu. Analysis of the diagnostic subgroups indicated that irrespective of the diagnosis, both treatments improved the efficacy criteria as observed for the entire population. The global assessment of the therapeutic efficacy by investigators and patients supported the results of the efficacy analysis with good to very good ratings in 70-90% of the cases. A good tolerability of both preparations was observed in this study with a low number of adverse events in the test group (5.8%).

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Infective Agents, Local; Candidiasis, Vulvovaginal; Dequalinium; Double-Blind Method; Female; Humans; Hydrogen-Ion Concentration; Middle Aged; Povidone-Iodine; Trichomonas Infections; Vaginal Discharge; Vaginal Diseases

Recent evidence has associated bacterial vaginosis and trichomoniasis with several postoperative complications. We carried out a prospective study aiming to estimate the frequency of vaginitis in women wanting to make an artificial abortion and the possibility to influence this infections by local application of vaginal BETADINE suppositories in all forms of infectious vaginitis: Candida albicans, trichomonas vaginalis and bacterial vaginosis.

Topics: Abortion, Legal; Anti-Infective Agents, Local; Candidiasis, Vulvovaginal; Female; Humans; Povidone-Iodine; Pregnancy; Pregnancy Complications, Infectious; Pregnancy Complications, Parasitic; Preoperative Care; Trichomonas Vaginitis; Vagina; Vaginitis; Vaginosis, Bacterial

Povidone-iodine pessaries (Betadine vaginal pessaries) containing 200 mg of povidone-iodine (PVP-I) in a water soluble base, are a widely used gynaecological preparation for treatment of vaginitis. We conducted a study on PVP-I pessaries at the reduced dose of one pessary daily for 7 days to suit conditions in Macau where patients are eager for a simple, short treatment course with confirmed clinical efficacy benefiting their professional and household essential requirements. Thirty-eight cases were selected for this particular clinical trial. These consisted of housewives, factory workers and professional girls (a sexually high risk group) who were suffering from vaginitis and complaining of vaginal discharge and irritation due to trichomonas, candida or non-specific vaginitis. After routine examination, including the collection of samples for microbiology, patients were treated with PVP-I pessaries 200 mg once a day for 7 days. The second microbiology samples were collected after the 7 day treatment period. Among the 38 cases, we had 30 cases with a complete record to allow us to make a summary and analysis of the trial. There were 14 cases of vaginitis due to yeasts and fungi infection, 3 cases of protozoa (trichomonas), and 13 cases due to non-specific pathogenic infections. 73.3% of cases had a complete symptomatic and microbiological cure and a further 16.7% had a microbiological cure with a good improvement in symptoms. No complications or side effects were found in the 7 days consecutive treatment course and inflammation quickly subsided during the course of treatment. PVP-I pessaries, used once daily for 7 days, seem to be an ideal treatment for cases who are likely to be unable to follow a longer treatment course.

Topics: Candidiasis, Vulvovaginal; Drug Administration Schedule; Female; Humans; Medical Records; Pessaries; Povidone-Iodine; Trichomonas Vaginitis; Vaginitis

Topics: Adolescent; Adult; Candidiasis, Vulvovaginal; Female; Humans; Middle Aged; Pessaries; Povidone; Povidone-Iodine; Vaginitis

One hundred and thirty-five women suffering from trichomonal, candidal, or both infections simultameously, were treated with povidone-iodine pessaries, 2 pessaries being inserted nightly. Ninety-nine women were given a 7-day course of treatment, but the results obtained were disappointing, and the authors do not recommend such a regime for routine treatment. Better results were obtained with the recommended 14-day course. A further 36 women suffering from chronic trichomonal and/or canidal infections which had previously resisted orthodox treatment were given a prolonged 28-day course of pessary treatment. The results obtained were very encouraging, 92% of the trichomonal and 96% of the canidal infections being cured. Furthermore, although povidone-iodine is slightly less effective in trichomoniasis, most patients suffering from a chronic infection (candidal, as well as trichomonal) were cured by the one preparation. Side-effects did occur, but were significant in only 3 patients. Subjective symptoms, especially any offensive odour, disappeared within 3 days of the start of the treatment. The authors recommend that the 28-day course of povidone-iodine pessaries is used in those cases where trichomoniasis or candidosis has been a therapeutic problem in the past, particularly if the patient is currently on the oral contraceptive pill.

Topics: Candidiasis, Vulvovaginal; Chronic Disease; Drug Evaluation; Female; Humans; Pessaries; Povidone; Povidone-Iodine; Time Factors; Trichomonas Vaginitis

A regimen of treatment for vaginitis combining the use of a povidone-iodine solution for swabbing, a povidone-iodine vaginal gel for application at night and a povidone-iodine douche for use in the morning, was evaluated in 93 courses of treatment in 87 patients with monilial or trichomonal vaginitis or a combination of both. In monilial vaginitis, symptoms were cleared and negative laboratory results obtained in one to three weeks in all 74 courses of treatment. These results were obtained within one week in 52 cases and within two weeks in another 17. In four of five patients with trichomonal vaginitis, symptoms were cleared within three weeks. In the fifth, negative laboratory results were obtained but a mild discharge persisted at the end of the fourth week. In 14 courses for combined infections, symptoms were cleared within three weeks in 13, and the pathogens were absent in those patients within four weeks. In one patient the disease did not respond.

Topics: Adult; Candidiasis, Vulvovaginal; Female; Gels; Humans; Povidone; Povidone-Iodine; Pregnancy; Solutions; Trichomonas Vaginitis; Vaginitis

Topics: Anti-Infective Agents, Local; Candidiasis, Vulvovaginal; Female; Halogens; Humans; Hydrocarbons, Halogenated; Iodine; Povidone; Povidone-Iodine; Trichomonas Vaginitis; Vaginitis; Vulvovaginitis