Intervention Review

Topical treatment for vaginal candidiasis (thrush) in pregnancy

  1. Gavin Young2,
  2. David Jewell3

Editorial Group: Cochrane Pregnancy and Childbirth Group

Published Online: 17 FEB 2010

Assessed as up-to-date: 30 JUN 2001

DOI: 10.1002/14651858.CD000225

Database Title

Additional Information

How to Cite

Young G, Jewell D. Topical treatment for vaginal candidiasis (thrush) in pregnancy. Cochrane Database of Systematic Reviews 2001, Issue 4. Art. No.: CD000225. DOI: 10.1002/14651858.CD000225.

Author Information

  1. 2

    Temple Sowerby Medical Practice, Penrith, Cumbria, UK

  2. 3

    University of Bristol, Division of Primary Health Care, Bristol, UK

*Sonja Henderson, Cochrane Pregnancy and Childbirth Group, School of Reproductive and Developmental Medicine, Division of Perinatal and Reproductive Medicine, The University of Liverpool, First Floor, Liverpool Women's NHS Foundation Trust, Crown Street, Liverpool, L8 7SS, UK. sonjah@liverpool.ac.uk. s.l.henderson@liverpool.ac.uk.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 17 FEB 2010

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Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

Vaginal candidiasis (moniliasis or thrush) is a common and frequently distressing infection for many women. It is even more common in pregnancy. There is no evidence that thrush in pregnancy is harmful to the baby.

Objectives

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

Search methods

We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (March 2001). We updated this search on 1 October 2009 and added the results to the awaiting classification section.

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

Ten 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). In turn, Nystatin was as effective as hydrargaphen in one trial (odds ratio 0.29, 95% confidence interval 0.05-1.84). 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 no more or less effective than three or four days treatment. However, two trials involving 81 women, showed that treatment lasting for four days was less effective than treatment for seven days (odds ratio 11.7, 95% confidence interval 4.21 to 29.15). 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). Terconazole was as effective as clotrimazole (odds ratio 1.41, 95% confidence interval 0.28- 7.10).

Authors' conclusions

Topical imidazole appears to be more effective than nystatin for treating symptomatic vaginal candidiasis in pregnancy. Treatments for seven days may be necessary in pregnancy rather than the shorter courses more commonly used in non-pregnant women.

[Note: The seven citations in the awaiting classification section of the review may alter the conclusions of the review once assessed.]

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Topical treatment for vaginal candidiasis (thrush) in pregnancy

Imidazoles are best but pregnant women may need longer (7 not 4 day) courses. Thrush is a common vaginal infection in pregnancy causing itching and soreness. There is no evidence that this yeast infection harms the baby. Antifungal creams are effective. Imidazoles (such as clotrimazole) are more effective than older treatments such as nystatin and hydrargaphen. Longer courses (7 days) cured more than 90% of women whereas standard (4 day) courses only cured about half the cases.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

在懷孕當中陰道念珠菌感染(鵝口瘡)所使用的局部治療

對於許多婦女來說，陰道念珠菌感染(念珠球菌病或是鵝口瘡)是1種常見而且經常會令人感到苦惱的感染病。至於在懷孕的時候，它的發生率更高。懷孕時候發生之鵝口瘡並沒有證據可以證實會對嬰兒產生危害

目標

本篇回顧的目的，是要評估在懷孕當中治療陰道念珠菌感染不同方法的功效

搜尋策略

我們搜尋了the Cochrane Pregnancy and Childbirth Group Trials Register。除此之外，還搜尋了the Cochrane Controlled Trials Register(CENTRAL/CCTR)。最後1次搜尋的日期為：2001年3月

選擇標準

這些隨機試驗的對象為懷孕當中的陰道念珠菌感染使用任何1種治療方法

資料收集與分析

有2位審稿者評估了試驗的品質，並擷取出資料

主要結論

其中共包含了10組試驗。根據裡面的5組試驗，在懷孕當中治療陰道念珠菌感染時，imidazol 類的藥物會比nystatin 還要有效(odds ratio 0.21, 95% confidence interval 0.16 to 0.29)。接下來要提的是，在其中1組試驗當中，nystatin的效力跟hydrargaphe 是相同的(odds ratio 0.29, 95% confidence interval 0.05 – 1.84)。還有1組試驗提到，clotrimazol 的效力比安慰劑要強(odds ratio 0.14, 95% confidence interval 0.06 to 0.31)。跟經過3天或4天的治療比較起來，單一劑量的治療並無差異。然而，有2組共包含了81名婦女在內的試驗顯示，能夠持續4天的治療，效力會低於持續了7天的治療(odds ratio 11.7, 95% confidence interval 4.21 to 29.15)。根據其中的2組試驗，跟14天的治療比較起來，進行了7天的治療並無差異(odds ratio 0.41, 95% confidence interval 0.16 to 1.05)。Terconazole 與clotrimazol 的效力是相同的(odds rati .41, 95% confidence interval 0.28 – 7.10)

作者結論

在懷孕的時候，對於治療有症狀的陰道念珠菌感染而言，局部使用imidazole會比nystatin有效。在懷孕當中，可能會需要用到7天的治療，而不是普遍使用在未懷孕之婦女身上的較短期療程

翻譯人

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌

總結

針對懷孕當中的陰道念珠菌感染(鵝口瘡)所使用的局部治療。Imidazoles是最佳的選擇，但是懷孕的婦女可能會需要更長期(7天而非4天)的療程。鵝口瘡是一種在懷孕當中常見的陰道感染，而且會引起騷癢與疼痛。並沒有證據顯示這樣的感染會對嬰兒造成危害。抗黴菌類的藥膏是很有效的。跟像是nystati 與hydrargaphen這些比較古早的治療方法比較起來，imidazole類的藥物(像是clotrimazole)有強的效力。較長的療程(7天)可以治癒超過90% 的婦女，至於標準(4天)的療程就只能治癒一半的案例

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