Abstract :
Objective:-The first purpose of the present work is in vivo (clinical study): A comparative study of oral and topical Ketoconazole in the treatments of P V and (second) in vitro (laboratory study): To determine the activity of Ketoconazole against M Furfur by (MIC) test. Study patients:- In vivo or clinical study included only one hundred and seventy eight outpatients. Each patient was examined clinically before treatment as well as by laboratory examination.. After treatment, cure was confirmed by wood’s light examination , 95 % of cases were no fluorescence while direct microscopic examination showed cure of first degree 64 % , 44 % , 40 % , 12 % in groups A , B , C , D respectively for yeast and for hyphae cure was100% ,100% , 100 % , 84 % in groups A , B , C , D respectively. Results: - With regard antifungal susceptibility test (MIC), our results showed that Ketoconazole was highly effective against 40 isolates of the fungus with MIC ranging from 0.03 – 0.5 μg/ml. MIC50 was 0.06 μg/ml and MIC90 was 0.25 μg/ml. However drug acts as fungicidal action (MFC) in 19 (47.5 %) of isolates and fungistatic action (MIC) in 21 (52.5 %) of isolates. The study concluded that ketoconazole was highly effective in vivo and in vitro., clinical trial reported the great cure in group A (200mg) followed by group B (400mg), then group C (2% cream) and group D (2% shampoo) was the less cure. Also, great side effect in group A followed by C, D then B
