Viginal discharge

First trimester of pregnancy Lactating mothers

Azithromycin Magnesium and aluminium containing antacids reduce the peak serum levels. Possible occurence of ergotism following concurrent use with azithromycin Co-administration of Digoxin or cyclosporine requires the monitoring of their serum levels. Fluconazole Azole antifungals increase the cyclosporine levels by slowing the metabolism of the drug. Fluconazole increases the concentration of phenytoin by inhibiting the drugs metabolism. The AUC of phenytoin was increased after 16 days of 200mg of fluconazole The concentration of cifabutin was increased to two-fold by fluconazole Administration of fluconazole to diabetic liver transplant patients on tacrolimus showed an increase in tacrolimus concentration and reversible nephrotoxiocity The bleeding time was increased in patients on warfarin Mean plasma clearance of theophylline was decreased by fluconazole Concentraion of zidovudine was increased following co-administration of fluconazole Fluconazole may increase the concentration of oral anticoagulants Secnidazole A disulfiram-like reaction has been reported following ingestion of alcohol during and up to 24 hrs after theapy with secnidazole and hence alcohol should be avoided. Secnidazole may potentiate the effect of warfarin and should not be administered to patients with a history of bleeding disorders.

Azithromycin Anaphylaxis, angioneurotic edema, diarrhea, nausea, cramping abdominal pain, flatulance, vomiting, headache, and dizziness Fluconazole Headache, nausea, abdominal pain, diarrhea, dyspepsia, dizziness, taste perversion, and rarely angioedema and anaphylactic reaction. Secindazole Nausea, gasrtigia, change of taste, metallic taste, stomatitis, urticaria, rashes, leucopenia, rarely vertigo, moderate neurological and digestive troubles.

Azithromycin Hypersensitivity to azithromycin or any other macrolide antibiotics Co-administration with ergot derivatives Hepatic disease, pregnancy, and lactation are relative contraindications. Fluconazole Hypersensitivity to fluconazole and other azole antifungals Co-administration with terfenadine or cisapride Advanced liver disease. Secnidazole Hypersensitivity to imidazole derivatives First trimester of pregnancy Lactating mothers

Indication: Vaginal discharge Dosage: Oral - Azithromycin : 1g administered 1 hr before lunch Fluconazole- 150mg single dose Secnidazole : 2g with food as a single oral dose.

Pharmacology: Fluconazole has been preferred first line therapeutic choice in vaginal candidiasis.. It has been shown to exhibit single dose efficacy, and infections treated with fluconazole show low rate of recurrence rate, since the drug eliminates rectal infections. Azithromycin has demonstrated excellant cure rates (95-100%) in the management of chlamydial and gonococcal infections with single dose therapy as compored to multidose therapy of antibiotics. Secnidazole has been relatively new anti-fungal that has demonstrated impressive therapeutic efficacy in the clinical setting. The longer half-life(17 hrs) of secnidazole compared to that of tinidazole (13hrs) means that the drug has a longer duration of action against causative organisms.