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At least 19 recordsLinked to original sources
PubMed1978

Seven-day clotrimazole therapy for vulvovaginal candidiasis.

There were 150 patients with mycologically proven vulvovaginal candidiasis in a randomized, non-cross-over study which compared seven-and 14-day treatment courses of clotrimazole vaginal tablets (Gyne-Lotrimin) with a 14-day treatment course of miconazole nitrate 2% vaginal cream (Monistat). Adequate data for analyses were obtained for 117 patients. When patients were reexamined four or more weeks after completion of therapy, success rates, based on clinical and mycologic criteria, were: 88% for patients treated with clotrimazole for seven days, 84% for clotrimazole 14-day treatment, and 78% for miconazole nitrate 14-day treatment. There were no drug-related adverse reactions. Thus a seven-day course of therapy with clotrimazole is effective as is a 14-day course of either clotrimazole or miconazole nitrate 2% for the treatment of Candida vaginitis. Statistical analysis revealed no significant differences among the clotrimazole seven-and 14-day treatment groups and the miconazole nitrate 14-day treatment group. The shorter period of administration required for this new antifungal agent should result in better patient compliance and an improved success rate in the rate in the treatment of this frequently encountered infection.

Adolescent↗
PubMed1979

The effect of clotrimazole on human lymphocyte responsiveness to plant mitogens.

The effect of clotrimazole, an imidazole derivative with anti-rheumatic properties, on lymphocyte stimulation by phytohaemagglutinin, concanavalin-A and pokeweed mitogen was investigated in an in vitro culture system. Evidence was obtained to show that the drug could either enhance or inhibit lymphocyte stimulation, the response depending on the concentration of the drug in the culture system and the mitogen used, as well as on individual variability. At a concentration of the drug corresponding to therapeutic serum levels, clotrimazole inhibited lymphocyte response to the three mitogens in all the normal volunteers studied. In addition, the effect of clotrimazole on in vitro mitogenic responsiveness of lymphocytes of a group of patients with rheumatoid arthritis taking this drug was compared to that of the proprionic acid derivative, ketoprofen. Patients taking clotrimazole showed a significant reduction in lymphocyte responsiveness, when compared to pre- and post-treatment levels, whereas there was no significant difference in those patients taking ketoprofen. Although cortisol levels tended to be higher in the groups of patients taking clotrimazole there was no correlation between lymphocyte responsiveness and cortisol concentration.

Arthritis, Rheumatoid↗
PubMed1978

Treatment of chronic oral candidiasis with clotrimazole troches. A controlled clinical trial.

Twenty patients with chronic oral candidiasis were assigned by random allocation to a two-week course of either 10-mg clotrimazole buccal troches or placebo taken five times daily in a double-blind clinical trial. Each of the 10 recipients of clotrimazole had marked regression of symptoms and mucosal lesions, and in nine patients potassium hydroxide preparations and cultures of mucosal scrapings gave no evidence of candidiasis. In contrast, only one of the 10 patients receiving placebo showed any improvement. The clinical outcome in the clotrimazole-treated group was significantly more favorable (P less than 0.001) than in the group receiving placebo. No adverse reactions to the drug were observed. After the blind phase of their trial, 15 patients were treated with clotrimazole troches in an open trial. One to three troches per day were found adequate to sustain remissions. We conclude that clotrimazole is highly effective treatment for chronic oral candidiasis.

Adolescent↗
PubMed1978

Vulvovaginal candidiasis treated with clotrimazole cream in seven days compared with fourteen-day treatment with miconazole cream.

Clotrimazole 1 per cent vaginal cream administered daily over a seven-day period was compared with miconazole nitrate 2 per cent vaginal cream administered daily over a 14 day period for the treatment of vulvovaginal candidiasis in a double-blind study of 65 women with clinical symptoms of this condition,, for whom treatment was randomly allocated. When efficacy of treatment was evaluated in 44 of these patients, a success rate, based on both clinical and mycologic criteria, of 75 per cent was found in the 20 patients treated with clotrimazole for seven days as compared with a 63 per cent success rate in the 24 patients treated with miconazole for 14 days. Of the 65 women enrolled in the study, two of the miconazole-treated patients experienced burning sensations, whereas the clotrimazole-treated patients experienced no adverse reactions. Thus, in this group of patients clotrimazole 1 per cent vaginal cream was shown to have a slightly, but not significantly, better efficacy than the miconazole nitrate 2 per cent vaginal cream, with no adverse reactions and in half the treatment time.

Adolescent↗
PubMed1977

Anti-Candida activity of clotrimazole in combination with dioctyl sodium sulfosuccinate and other surfactants.

Six anionic and five nonionic surfactants were tested for their effect on the fungistatic action of clotrimazole against Candida albicans. All of the anionic agents that did not contain an ethylene oxide group were capable of potentiating the anti-Candida activity of clotrimazole, whereas all five members of the polyoxyethylene surfactant group, including four nonionic agents and one anionic agent, acted in an antagonistic fashion. The combination of clotrimazole and the anionic surfactant dioctyl sodium sulfosuccinate was the most potent in synergy and, thus, more precise studies were made with this combination. Although appropriate combinations of the two drugs showed a potent fungicidal activity against proliferating cultures, none of these combinations tested was lethal when cell growth was restricted by nutritional deficiency. The lethal effect of the combined drugs was partly reversed when growing cultures were treated in the presence of an osmotic stabilizer. Whether cells were treated with moderate and higher concentrations of clotrimazole and dioctyl sodium sulfosuccinate, alone or in combination, there was little change in cell wall content of total protein, carbohydrate, or lipid from that in untreated control cells. However, there was a significant decrease in the cell wall content of phospholipid when moderate concentrations of the two drugs were combined.

Candida albicans↗
PubMed1978

Vulvovaginal candidiasis in pregnancy treated with clotrimazole.

An open trial of local clotrimazole therapy in 56 pregnant women with vulvovaginal candidiasis is reported. The diagnosis was confirmed by mycotic culture. The patients were given one vaginal tablet daily and cream was applied to the vulva 2 or 3 times daily. Their male partners were treated with cream only. The duration of therapy was 6 days. Fifty of the patients (89.3%) were clinically cured after 6 days of therapy. Six patients (10.7%) had slight complaints and 10 (17.9%) without symptoms or signs of infection harboured Candida albicans or other yeast species in the genital tract. Six of the patients were given a second treatment with clotrimazole and their remaining symptoms subsided. Candidiasis recurred later in pregnancy in 4 of the 56 patients studied. The implications of the presence of Candida in the genital tract are discussed. It is concluded that clotrimazole is an effective antimycotic agent which can be used for vulvovaginal candidasis during pregnancy without causing side effects. Two of the patients had trichomoniasis concurrently. One of these was cured with clotrimazole.

Administration, Topical↗
PubMed1977

Topical clotrimazole in tinea pedis.

Clotrimazole is a new antifungal agent which is effective topically in dermatophytosis, cutaneous candidiasis, and tinea vesicolor. The authors performed a controlled double-blind clinical trial comparing topical clotrimazole with its vehicle in the treatment of 66 patients with dermatophytic infections of the skin of the feet. Clotrimazole proved to be effective in the treatment of tinea pedis of both the interdigital and the plantar hyperkeratotic types.

Administration, Topical↗
PubMed1977

Basic experiments with clotrimazole administered orally.

A series of experiments was carried out with the antimycotic agent clotrimazole to establish MICs against a number of different yeasts and to estimate its blood levels following oral administration. Marked differences were noted between the MIC against A and B serotypes of Candida albicans in its yeast-like cell form, that against Type B being nearly 10-times higher than against Type A. Against the mycelial form, however, the MIC was much lower and there was little difference between the levels for the two serotypes. Clotrimazole administered in oral tablet form appeared to be poorly absorbed, little being transferred to the blood. Urinary levels were low and large amounts of the drug were detected in the faeces. Serum levels were below MIC levels in all cases examined. Blood levels 3-times as great as those after the same dosage in tablet form were produced when clotrimazole was given in oil solution and even with 250 mg, effective blood levels were achieved and maintained.

Administration, Oral↗
PubMed1977

Superficial mycoses: treatment with a new, broad-spectrum antifungal agent: 1% clotrimazole solution.

A 1% clotrimazole solution was used as an antifungal for Tinea versicolor, Cutaneous Candidiasis and Dermatophytosis. All studies were double-blind and controlled, active vs vehicle. The final evaluation was made at a two-week follow-up after the treatment was stopped, which for most of the clinical conditions studied, was 28 days. The 1% clotrimazole solution was found to be effective with no local irritation noted.

Candidiasis, Cutaneous↗
PubMed1979

Chronic mucocutaneous candidiasis. Successful treatment with intermittent oral doses of clotrimazole.

Treatment of chronic mucocutaneous candidiasis has included drugs, immunotherapy, and replacement of nutritional and endocrine deficiency. Although amphotericin B is the best known and most commonly used form of treatment, the imidazole antibiotic clotrimazole has shown promise as an effective agent that can be given orally with low toxicity. A 9-year-old girl responded to intermittent clotrimazole therapy with complete and prolonged remission. This form of treatment offers advantages in safety and effectiveness over other therapies for chronic mucocutaneous candidiasis.

Administration, Oral↗
PubMed1977

Antagonistic action of lipid components of membranes from Candida albicans and various other lipids on two imidazole antimycotics, clotrimazole and miconazole.

The growth-inhibitory activity of two imidazole antimycotics, clotrimazole and miconazole, against Candida albicans was significantly reversed when lipid extracts from protoplast membranes of the same organism were added to the assay medium together with the drugs. Of four major classes of lipids further separated from them, viz., phospholipids, triglycerides, sterol esters, and free sterols, the former two were capable of counteracting both drugs, whereas the latter two were not. However, even with phospholipids or triglycerides, no antagonism was noted when they were saturated by catalytic hydrogenation before use. The antagonistic effect of varying classes of commercial lipids, including phospholipids, acylglycerides, sterols, and fatty acids, was also studied by means of the agar diffusion technique. Significant antagonism to both drugs was observed with: (i) phospholipids with an unsaturated acyl group; (ii) acylglycerides, the ester portion of which consists of unsaturated fatty acid; (iii) ultraviolet-activated sterols; and (iv) unsaturated fatty acids of cis-configuration. By contrast, none of the saturated phospholipids and acylglycerides nor sterols was effective as an antagonist. With the exception only of lauric acid, all of a series of saturated fatty acids and unsaturated trans-fatty acids ranging from C(8) to C(18) in chain length were either minimally effective or completely ineffective. Essentially, there was no qualitative difference between clotrimazole and miconazole in the response to these various lipids.

Candida albicans↗
PubMed1977

[Clotrimazol therapy of skin mycoses].

Clinical evaluation of a 1% clotrimazole cream and solution on 236 in and out patients with different clinical manifestations of mycotic infections was done. Clotrimazole, both cream and solution, is an effective and well tolerated agent in the treatment of infections due to dermatophytes and yeasts. Best results were recorded with patients suffering from pityriasis versicolor and erythrasma, and interdigital erosion.

Administration, Topical↗
PubMed1978

Protection by unsaturated lecithin against the imidazole antimycotics, clotrimazole and miconazole.

The activity of egg lecithin in preventing the antifungal action of the two imidazole antimycotics, clotrimazole and miconazole, was confirmed. However, addition of this phospholipid could not relieve an existing imidazole inhibition. Compared with egg lecithin, reduced egg lecithin showed no such protective effect. The addition of egg lecithin to an aqueous suspension of the imidazole drugs changed the absorption profile of the imidazole, suggesting a low solubility and, consequently, a lower effective concentration; however, the addition of reduced egg lecithin did not produce any change in the adsorption. These results indicate that the preventive effect of egg lecithin on imidazole inhibition may be a consequence of preferential in vitro interaction of the drug with unsaturated phospholipid to form a hydrophobic complex.

Absorption↗
PubMed1977

The frequency of Candida infections in pregnancy and their treatment with clotrimazole.

In an open study, 243 pregnant women were investigated for Candida infection of the vagina. Clinical diagnosis, confirmed by culture, showed that 163 (56%) were infected at some time during pregnancy. Infected patients were treated for 6 days with clotrimazole, I vaginal tablet per day plus cream applied externally. Treatment was considered as well accepted by all, and as successful in 84% of cases in the first trimester, 87% in the second, and 78% in the third trimester. There was no evidence of a relationship between Candida infection of the mother and the incidence of abortion or other disease of the newborn. It is suggested that early treatment of Candida infections of the vagina during pregnancy can greatly reduce the incidence of fungal infections in the newborn. In this series, only 3 of the 200 live births had a post-partum fungal infection: all were delivered by Caesarian section and the infection was not recorded until the third month in hospital.

Abortion, Spontaneous↗
PubMed1978

In vitro studies of amphotericin B in combination with the imidazole antifungal compounds clotrimazole and miconazole.

The clinically important polyene antibiotic amphotericin B, in combination with two antifungal imidazole compounds, clotrimazole and miconazole, was studied in vitro. With use of results of cytoplasmic leakage, metabolic heat output, and minimal inhibitory concentration studies, a definite antagonistic response was demonstrated. It is suggested that, if combined antifungal drug therapy is clinically indicated, the drug combination be tested against the isolate by the simple technique of measuring cytoplasmic leakage or by the more elaborate method of flow microcalorimetry.

Adsorption↗