British Association for Sexual Health and HIV national guideline for the management of vulvovaginal candidiasis (2019)

Saxon, Guideline Development Group: Cara; Edwards, Anne; Rautemaa‐Richardson, Riina; Owen, Caroline M.; Nathan, Bavithra; Palmer, Bret; Wood, Clare; Ahmed, Humera; Ahmad, Patient Representatives Sameena; FitzGerald, Mark

doi:10.1177/0956462420943034

Cited by 33 publications

(22 citation statements)

References 143 publications

(233 reference statements)

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“…За умови зникнення симптомів немає потреби проводити контрольні лабораторні дослідження після лікування БВ, АВ, ВВК [3,5,44].…”

Section: контроль вилікуваності основних мікробних причин аввunclassified

“…За рекомендаціями CDC (2021), через високий рівень реінфекції в жінок, які лікуються, при трихомоніазі потрібно проводити повторне тестування на Таблиця 4. Визначення різних форм ВВК і рекомендовані методи їх діагностики IUSTI (2018) [5], BASHН (2019) [44] CDC (2021) [3] Гострий Такі доступні дослідження, як визначення рН і мікроскопія вагінальних виділень з оцінюванням за критеріями діагностики дисбіозів, є першою лінією діагностики БВ, АВ та ВВК. Саме вони дозволяють провести диференційну діа гностику з немікробними причинами АВВ та рідкісними причинами мікробних АВВ.…”

Section: контроль вилікуваності основних мікробних причин аввunclassified

“…(оцінювання результатів відповідно до таблиці 2) * обґрунтовані доказами рекомендації з лікування основних мікробних причин АВВ[3][4][5]44]. № 5(61)/листопад 2021 WWW.REPRODUCT-ENDO.COM / WWW.REPRODUCT-ENDO.COM.UA ISSN 2309-4117 ГІНЕКОЛОГІЯ СУЧАСНІ ЛАБОРАТОРНІ МЕТОДИ В ДІАГНОСТИЦІ ПРИЧИН АВВ З огляду на не до кінця зрозумілі механізми регуляції вагінального біоценозу і зміни патогенності умовно-патогенної та патогенної флори, що призводять до зростання частоти змішаних форм вагінозів і їхнього атипового перебігу, лабораторна складова діагностики причин АВВ має бути комплексною.…”

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Practical approaches to examination of women with abnormal vaginal discharge: a review of evidence-based recommendations 2021

Бурка

Shumytskyi²,

Семенюк³

et al. 2021

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Abnormal vaginal discharge (AVD) is a syndrome that combines conditions of different origin (microbial/non-microbial) and of different anatomical localization (limited to vagina and exocervix/spreading from the endocervix to the pelvic organs) that cause discomfort and changes in the characteristics of vaginal discharge.Review objective: to systematize modern approaches to the diagnosis of the most common causes of AVD – bacterial vaginosis (BV), trichomoniasis, aerobic vaginitis (AV), vulvovaginal candidiasis (VVC) – in a practical context. Laboratory component of diagnosing the AVD causes should be complex due to the not fully understood mechanisms of regulation of vaginal biocenosis and changes in the virulence of opportunistic and pathogenic flora, leading to an increase in the frequency of mixed forms of vaginosis and their atypical course. The tasks of laboratory tests in AVD are determination of the sexually transmitted infections (gonorrhea, chlamydia, Mycoplasma genitalium) more often as a concomitant asymptomatic infection in combination with BV or another cause of AVD; confirmation of the suspected cause of AVD (BV, trichomoniasis, AV, VVC); differential diagnosis with more rare microbial causes (cytolytic vaginosis) and non-microbial causes.Vaginal pH and microscopy of vaginal discharge with an assessment according to the diagnostic criteria for dysbiosis are first line of available diagnostic tests of BV, AV and VVC. They make it possible to differentiate typical AVD causes from non-microbial AVD causes and rare causes of microbial AVD. Additionally, complex modern molecular methods for assessing the vaginal biocenosis can be used. Cultural methods play an important role in the diagnosis and treatment of recurrent/complicated VVC and AV. PCR for chlamydia, gonorrhea, trichomoniasis and Mycoplasma genitalium is a mandatory component of a comprehensive test in patients with suspected BV, AV or mixed dysbiosis. Patients diagnosed with BV or trichomoniasis has to be tested for HIV and sexually transmitted infections.

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Section: контроль вилікуваності основних мікробних причин аввunclassified

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Practical approaches to examination of women with abnormal vaginal discharge: a review of evidence-based recommendations 2021

Бурка

Shumytskyi²,

Семенюк³

et al. 2021

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“…4 British Association for Sexual Health and HIV Guidelines recommend nystatin pessaries for treatment of women with suspected or confirmed azole resistant RVVYI as this is currently the only UK-licensed alternative. 5 However, options are limited for cases where nystatin does not result in elimination of the yeast. 3 Boric acid pessaries can be obtained from specialist wholesalers, but supply issues are common with these and with nystatin.…”

Section: Introductionmentioning

confidence: 99%

“…5 Topical amphotericin B and flucytosine products were previously obtainable as expensive ‘made to order’ items but are no longer available. 2,5…”

Section: Introductionmentioning

confidence: 99%

Outcomes and experiences of using oral voriconazole with or without concomitant topical agents to treat refractory vulvovaginal yeast infections

et al. 2022

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Background We describe 11 cases of refractory vulvovaginal yeast infections (RVVYI) treated using oral voriconazole with or without concomitant topical agents. Methods Retrospective case-note review of all women prescribed oral voriconazole to treat RVVYI in five Sexual Health Clinics from Jan 2010-March 2020. Demographic details, clinical features, diagnostic results and treatment outcomes were collected. Results 11 women with vulvovaginal symptoms for a median of 1 year were treated with voriconazole. RVVYI was diagnosed clinically and confirmed on microscopy and culture with speciation. 10/11 isolates were fluconazole resistant, 1 intermediately sensitive, 10/11 were either fully or intermediately sensitive to voriconazole. All had received prior fluconazole and clotrimazole and 10/11 had used at least 2-weeks of one or more second-line antifungals with non-clearance of the yeast. Oral voriconazole 400 mg BD day-1, then 200 mg BD 13-days was prescribed and 10/11 women completed the course. Concomitant topical treatment was used by 6/11. Liver and renal function were monitored at 0, 7, 14 days. One woman stopped voriconazole after 5-days due to perioral tingling. Other transient side-effects were nausea ( n = 2), photosensitivity, muscle aches, hair thinning (all n = 1), peripheral visual disturbance ( n = 2). 8/11 experienced both symptom reduction and yeast clearance. Two women had an initial partial response but experienced resolution of symptoms following a second course of voriconazole. Conclusions Our observational data adds to the limited evidence to support voriconazole treatment for RVVYI. A 2-week course of voriconazole was tolerated and completed by 10/11 women. Eight women, five using concomitant topical agents, achieved mycological cure.

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Vulvovaginal Candidiasis

Sethi¹

2022

Ridley's the Vulva

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British Association for Sexual Health and HIV national guideline for the management of vulvovaginal candidiasis (2019)

Cited by 33 publications

References 143 publications

Practical approaches to examination of women with abnormal vaginal discharge: a review of evidence-based recommendations 2021

Practical approaches to examination of women with abnormal vaginal discharge: a review of evidence-based recommendations 2021

Outcomes and experiences of using oral voriconazole with or without concomitant topical agents to treat refractory vulvovaginal yeast infections

Vulvovaginal Candidiasis

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