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Candida albicansFrom: Ron Ainsworth (ainsron@msn.com)Thu Mar 2 09:31:37 2000
Several years ago, I became annoyingly aware that Pacificare's formulary does not cover terconazole for treatment of vulvo-vaginal candidiasis. On the other hand they do cover miconazole, clotrimazole and fluconazole. From what I am aware, those three drugs all have similar coverage and miss the non-albicans Candida sp. Most patients who come in have already tried OTC available drugs, and if they have not responded, it makes little sense to retry more of same. In my experience, terconazole is a much better treatment choice, for 3 or 7 days. I'm currently trying to get Pacificare to add terconazole, and have to come up with three articles from "peer reviewed literature" to support my contention! My question is does anyone out there actually prescribe Monistat or GyneLotrim as first-line therapy, or do you all go to Terazol for your first choice? About the only time I prescribe Diflucan is when a patient specifically requests the "one day pill" or has done well on it in the past.
-- Ronald E. Ainsworth, MD
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