REVIEWS   

Minerva Ginecologica 2013 December;65(6):707-15

Copyright © 2013 EDIZIONI MINERVA MEDICA

language: Italian

Topical treatment of vaginal infections by the association of metronidazole-clotrimazole

Tavassoli K. ¹, Mattana P. ² ✉

¹ Professore a. c. di Diagnostica Strumentale e Metodologia Chirurgica Università di Torino, Torino, Italia; ² Medical Service, Alfa Wassermann Bologna, Italia

Vaginal infections are one of the most gynecological frequently diseases observed and with significant psychological and clinical implications. Their pharmacological treatment may require different options, but even today, scientific literature and international guidelines recommend the use of metronidazole for the treatment of bacterial vaginosis (BV) and trichomoniasis, and the clotrimazole for fungal infections from Candida (VVC). In this contest, the topical association of clotrimazole-metronidazole (vaginal pessaries, cream and douches) represents a current reference treatment for these types of infections with a number of important pharmacological properties. This combination allows an effective activity against to a broad spectrum of pathogens (bacterial, fungal and protozoan), a feature particularly relevant in the case of mixed infections. Furthermore it allows a synergistic action that improve the therapeutic abilities of the individual components, a reduction of the spontaneous resistance of some microorganisms and the activity against symptoms and signs of vaginal inflammation with maintaining the vaginal ecosystem, since they have no activity against endogenous lactobacilli. Finally, recent studies have shown the ability of the topical association of metronidazole-clotrimazole to inhibit the in vitro phenotypic switching of Candida albicans, and its effectiveness against Recurrent Vulvovaginal Candidiasis (RVVC).