The value of treating the sexual partners of women with recurrent vaginal candidiasis with ketoconazole.

OBJECTIVE To determine whether treatment of the sexual partners of women with chronic vulvovaginal candidiasis with oral ketoconazole can reduce the recurrence rate of candida vaginitis. DESIGN Single blind randomised study where all the women were treated with ketoconazole 400 mg daily for 7 days after an acute episode of candida vaginitis and half the male partners were treated with ketoconazole 200 mg daily for 5 days. SETTING Women's Candida Clinic of St. Michael's Hospital, a University of Toronto teaching Hospital, Toronto, Ontario, Canada. SUBJECTS Fifty-four women attending the clinic with at least four proven episodes of candida vaginitis and their male sex partners (stable monogamous relationships) were enrolled in the study. MAIN OUTCOME MEASURES Clinical recurrence of candida vaginitis with confirmation by smear and culture. Follow-up was obtained one to two weeks after initial treatment, then monthly for one year. RESULTS In the control group (untreated partners), 20 of 28 (71%) patients had recurrences in six months, versus 17 of 26 (65%) patients in the treated group (treated partners) (95% Confidence Interval (CI) for the difference in recurrence rate = -19% to 31%). At one year, 23 of 28 (82%) patients in the control group had recurrences, versus 22 of 26 (85%) in the treated group (CI = -23% to 17%). CONCLUSION Treatment of the male partners, with a brief course of ketoconazole, is not of value in reducing the incidence of relapse in women with recurrent vaginal candidiasis. It is unlikely that a larger study would show a clinical important difference.