By JANET McCONNAUGHEY

Associated Press Writer

Women who get lots of painful yeast infections can safely ward them off with a weekly pill, the largest study on the subject has found.

Regular, preventive doses of an antifungal drug for six months dramatically cut the number of episodes. But it wasn’t a cure: Over time, infections recurred in many women.

Three out of four women get at least one vaginal yeast infection sometime in their lives. One dose of a drug called fluconazole, or a week of nonprescription cream, can stop the itching, burning and discharge.

But up to 8 percent of all women get four or more of these infections a year, some as often as once a month.

“Then it almost rules your life,” said Dr. David A. Eschenbach, chairman of the Department of Obstetrics and Gynecology at the University of Washington Medical Center.

The study of whether fluconazole works as a preventive treatment was reported in Thursday’s New England Journal of Medicine and was led by Dr. Jack D. Sobel, chief of infectious disease at Wayne State University School of Medicine in Michigan.

The study looked at 387 women suffering from recurrent Candida albicans, the most frequent cause. Each got three fluconazole pills three days apart. For the next six months, half took a weekly dose and half took lookalike dummy pills.

At the end of six months, 91 percent of those on fluconazole were clear of the yeast, compared with 36 percent of the placebo group. During the next six months, nearly 43 percent of the women who had taken fluconazole stayed disease-free, compared with 22 percent of those on the placebo.

The study was underwritten by Pfizer, which makes the fluconazole pill Diflucan. Half the researchers and Eschenbach have financial ties to Pfizer or other drug companies.

Sobel said he hopes his study will end insurers’ reluctance to pay for long-term use of fluconazole. Diflucan costs up to $30 a pill – five times the price of the least expensive over-the-counter cream – though new generics are pushing down the price.

Yeasts are normal inhabitants of the body. But if something goes out of kilter, they can multiply wildly. Sometimes pregnancy, diabetes, antibiotics, steroids or a weakened immune system cause the overgrowth. Sometimes the cause is unknown.



On the Net:

http://nejm.org

http://www.cdc.gov/ncidod/dbmd/diseaseinfo/candidiasis-gen-g.htm



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