***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Pregnancy is a well-known predisposing factor for vaginal c and idosis . Relapses are frequent , even after successful treatment , and the therapeutic approach must aim at safety for the mother and her unborn child as well as maximum comfort for the patient , since she is more likely to suffer repeated attacks of this uncomfortable condition . Vaginal infection at delivery may entail contamination of the newborn and , although mostly benign , this condition may be associated with feeding problems and chronic skin irritation . It is thus important to have an efficient therapy for as short a time as possible . Although longer treatment ( 5 days or more ) may ensure lower relapse rates , as demonstrated in clinical studies , shorter treatments may be preferred when delivery is closer at h and . In the present study , a 1 -day treatment with one 240-mg suppository of terconazole provided a 85 % cure rate , quite comparable with a 3-day regimen with either terconazole ( 3 × 80 mg ) or clotrimazole ( 3 × 200 mg ) . Only 1 patient in the clotrimazole group mentioned itching and burning as a side-effect At the UCLA Vulvovaginitis Clinic , 63 patients were diagnosed as having symptomatic C and ida albicans vaginal infections . In a r and om select manner 3-day treatment with 200-mg clotrimazole suppositories was compared with 7-day treatment using 100-mg clotrimazole suppositories . 7- and 35-day follow-up of all patients entered revealed no statistical difference between the two groups , suggesting that short-term treatment is most efficacious and can be expected to work better since patient compliance is primarily a function of duration of treatment . In 50 cases of C. albicans patients treated with miconazole or clotrimazole in a r and om manner , the recurrence rate was 8 or 16 . All patients in the study received perianal cultures for C. albicans before treatment and 7 and 35 days after treatment . 5 of the 8 patients with recurrence had perianal positive cultures at the 7- and 35-day check suggesting this as a source of recurrence . It is suggested that patients with persistently high perianal cultures after treatment be given an oral fungicide or fungistat to lower chronic recurrent C. albicans Summary A double-blind comparison of nystatin ( ‘ Nystan ’ ) pessaries and hydrargaphen ( ‘ Strong Penotrane ’ ) pessaries for the treatment of vaginal c and idosis showed that the former is more effective on clinical and mycological assessment . Relief from symptoms was obtained in 95.9 % and 84.6 % of the patients treated with nystatin and hydrargaphen respectively . On stopping treatment , yeasts could no longer be isolated from 75.0 % of the cases receiving ' Nystan ' and from 23.1 % receiving ' Strong Penotrane ' . There was no evidence of resistance to either drug before , during or after therapy Monistat Cream ( miconazole nitrate 2 % ) , a new fungicidal agent indicated for the treatment of vulvovaginal c and idiasis , was evaluated in a comparative study with nystatin vaginal tablets ( 100,-000 units each ) . A total of 95 pregnant and non-pregnant patients were treated .  Miconazole nitrate was administered once daily , at bedtime , for 14 days to 55 pregnant and non-pregnant patients . Overall , 74.5 % ( 41 of 55 patients ) were cured with one course of therapy . In contrast , of 40 nystatin-treated patients ( both pregnant and non-pregnant ) treated twice daily for 15 days , 22 patients ( 57.8 % ) were cured with one course of therapy . This difference in cure rates was statistically significant . Side effects were minimal and comparable in the two treatment groups . No recorded instances of birth defects were observed in infants born to mothers in either treatment group . Monistate Cream , in this study , was found to be a safe and effective drug in treating both pregnant and nonpregnant patients with confirmed c and idiasis Summary : : The effectiveness of a lytic enzyme preparation ( Elase*–Parke‐Davis ) plus natamycin ( Pimafucin – Gist‐Brocades ) was compared to natamycin therapy alone in a controlled clinical trial involving 120 patients suffering from monilial vulvo‐vaginitis . The results indicate that addition of Elase to a natamycin treatment regimen increases the effectiveness of therapy both with respect to alleviation of symptoms and to eradication of the organism as determined by vaginal culture in patients with acute infection and in those in whom infection is complicated by pregnancy or diabetes A r and omized multiregimen clinical study was undertaken using Monistat Cream for the treatment of vulvovaginal c and idiasis . The objective of the study was to find if there is a shorter regimen comparable in effectiveness to the currently marketed 14-day regimen . The results indicate that there is no significant difference between the cure rate obtained for 7 days of therapy and for 14 days of therapy The authors estimated the biocenosis of vagina in women before delivery . The examination were made upon 50 women between 28 and 40 week of pregnancy and on the third day after delivery ; comparing the results of estimation the purity of vagina and bacterial inoculations in two groups of pregnant women:-control group ( without G-P 150 treatment ) and in group with G-P 150 application .  The authors proved the entire disappearance of mycotic infection ( c and ida albicans ) in women treated with G-P 150 . The also stated that potential pathogenic bacterial flora during puerperium occurs much more rarely The activity and tolerance of 200 mg clotrimazole vaginal tablets and 150 mg econazole vaginal ovules were compared in the treatment of vaginal c and idiasis in a controlled multicentre ( 3 centres ) study . Treatment was allocated according to a r and omized list and each investigator treated 20 patients per group . The duration of therapy was 3 days . Follow-up investigations were carried out approximately 1 week and 4 weeks after commencement of treatment . The results were analyzed for 54 patients treated with clotrimazole and 57 with econazole : 9 patients were excluded from the analysis because of insufficient data . At the first follow-up examination , 1 week after starting therapy , 93.7 % of patients on clotrimazole and 83.7 % of patients on econazole had negative cultures . The success of therapy , as judged by the clinicians , was 95.8 % for clotrimazole and 88.0 % for econazole . For the first and fourth week combined review s , 86.0 % of clotrimazole patients and 77.8 % of econazole patients had negative cultures and the success of therapy was 88.4 % for clotrimazole and 80.0 % for econazole . These differences were not statistically significant but there was a clear numerical superiority for clotrimazole .  Tolerance was good in all the patients and no side-effects were observed Nystatin ( 100 000 units/day for 14 days ) and clotrimazole ( 100 mg/day for 6 days ) were equivalent to miconazole ( 100 mg/day for 14 days or 100 mg twice daily for 7 days ) in curing vaginal c and idiasis . However significantly more patients relapsed in the nystatin and clotrimazole groups than in either of the miconazole groups Single-dose treatment of vulvovaginal c and idiasis with a 500 mg clotrimazole vaginal tablet was compared to 3-day treatment with two 100 mg vaginal tablets administered daily in 115 patients enrolled in a double-blind trial , 101 of whom were evaluated for efficacy . Patients with clinical ly and mycologically active disease were treated ( visit 1 ) and examined at 5 to 10 days ( visit 2 ) and again at least 27 days ( visit 3 ) post treatment . At visit 2 , mycologic tests and clinical examinations were negative in 37 of 48 patients receiving single-dose treatment ( 77 % ) and in 47 of 53 patients receiving 3-day treatment ( 89 % ) . Corresponding results for visit 3 were 65 % and 74 % , respectively . There were no significant differences in treatment response between groups , and only three patients reported adverse reactions . These data show that single-dose treatment with clotrimazole , 500 mg , is as safe and effective as the more complex 3-day regimen Three hundred and thirty Black pregnant patients attending the Baragwanath Hospital antenatal clinic were treated for symptomatic vaginal discharge with econazole ( Ecostatin ; Squibb ) .  Patients with positive C and ida albicans cultures were treated for either 7 or 14 days . The results of treatment in both groups are presented Summary A multi-centre , double-blind controlled study in eleven hospitals was carried out to assess the efficacy , tolerance and patients ' acceptance of a new ‘ Mycostatin ’ effer-vescent vaginal tablet ( E.V.T. ) . One hundred and ninety-one patients received the effervescent tablet and 96 patients the currently-available ‘ Mycostatin ’ pessary .  Both formulations , containing 100,000 units of nystatin per pessary or tablet , were initially prescribed as one tablet or pessary nocte for 14 days . The patients selected had signs and symptoms of c and idal vaginitis confirmed by either a positive wet smear or culture for C and ida albicans .  The new effervescent formulation disintegrated and dispersed completely , result ing in a more uniform distribution of the active material throughout the vaginal walls ( p = 0.002 ) . After 14 days treatment 87 % of the patients were clinical ly and mycologically clear of c and idal vaginitis . A further 7 days therapy with one E.V.T. twice daily result ed in a complete cure in all but 5 patients ( 2 Patients with mycologically proven symptomatic fungal infections of the vagina were treated ina double-blind trial with either one 100-mg clotrimazole vaginal tablet daily for seven days ( group I ) or two tablets daily for three days ( group II ) . Patients were evaluated at one and four weeks after therapy . The investigator 's evaluation of treatment efficacy showed 85 % ( 22/26 ) success in group II compared with 75 % ( 21/28 ) in group I ( P = 0.46 ) . Both groups had improvement itching , discharge , and vaginal and vulval irritation . No significant ( P less than 0.10 ) differences were seen between groups after therapy . Only three side effects were seen . It is concluded that a three-day course of two clotrimazole vaginal tablet daily is as effective and safe as the previously recommended one tablet daily for seven days , and the shorter therapy is likely to improve patient compliance Econazole nitrate ( Ecostatin ; Squib ) in two dosage schedules , 150 mg per day for 3 days and 50 mg per day for 14 days , was found to be extremely effective , with cure rates of 84,9 % and 92,4 % respectively . As judged by symptomatic and clinical relief , recurrence rates and cure rates according to results of culture , there was no statistically significant difference between the two regimens . On the basis of the results of this trial and because of the advantages it offers , the shorter course can confidently be recommended as the initial treatment in c and idal infections A trial of clotrimazole and nystatin was made in 50 obstetrical and gynaecological patients with mycological evidence of vaginal moniliasis . Treatment for six days result ed in a higher eradication rate with clotrimazole ( 96 per cent ) than with nystatin ( 76 per cent ) and a comparable decrease in symptoms and signs . Four weeks after the end of treatment the recurrence rates in those patients with negative cultures immediately after therapy were 12.5 per cent with clotrimazole and 26.4 per cent with nystatin .  No significant adverse effects were noted in either group of patients A multicenter , double-blind study of 103 patients with clinical ly and mycologically documented vulvovaginal c and idiasis compared single-dose treatment with a 500 mg clotrimazole vaginal tablet to 3-day treatment with two 100 mg clotrimazole vaginal tablets administered daily . Patients were examined 5 to 10 days ( visit 2 ) and at least 27 days ( visit 3 ) post treatment . At visit 2 , mycologic and clinical examinations were negative in 43 of 48 efficacy-evaluable patients receiving clotrimazole , 500 mg ( 90 % ) , versus 42 of 47 efficacy-evaluable patients receiving clotrimazole , 200 mg ( 89 % ) . Similarly , at visit 3 , 75 % of patients receiving clotrimazole , 500 mg , had treatment success versus 72 % receiving clotrimazole , 200 mg . There were no significant intergroup treatment differences , indicating that single-dose treatment with clotrimazole , 500 mg , is equipotent to the multidose regimen From an open comparative multicentric trial it became clear that econazole was an active and well-tolerated agent for the treatment of vulvo-vaginal mycoses .  Combined treatment with pessaries and econazole cream seems to be worthwhile in order to isolate the vagina from possible C and ida reser 
    Output:
    
REVIEW ER 'S CONCLUSIONS Topical imidazole appears to be more effective than nystatin for treating symptomatic vaginal c and idiasis in pregnancy .