Prevalence of vulvovaginal candidiasis in gynecological practices in Germany: A retrospective study of 954,186 patients

Abstract

Background and Purpose:To the best of our knowledge, no information is available regarding the treatment of vulvovaginal candidiasis in gynecological practices. The goal of this study was to analyze the prevalence of vulvovaginal candidiasis (VVC) and the drugs prescribed for the treatment of this condition in women followed in gynecological practices in Germany.Materials and Methods:All the women followed in 262 gynecological practices between November 2014 and October 2016 were included in this study. The first outcome was the prevalence of patients diagnosed with VVC during this period. The second outcome was the prevalence of women with VVC who received an appropriate vaginal or systemic antimycotic prescription within 30 days after their first VVC diagnosis. Covariables included the use of gynecological/systemic antibiotics, consumption of oral/vaginal contraceptives, cancer, pregnancy, diabetes, and psychiatric diseases including depression, anxiety, and adjustment and somatoform disorders.Results:Between 2014 and 2016, 954,186 women were followed in gynecological practices, and 50,279 (5.3%) women were diagnosed with VVC during the same period. The use of gynecological antibiotics (OR=2.88), systemic antibiotics (OR=1.45), oral contraceptives (OR=1.74), and vaginal contraceptives (OR=1.84) were associated with an increase in the risk of VVC diagnosis. Cancer (OR=1.20) and pregnancy (OR=1.59) were additional risk factors. Approximately 75% of women diagnosed with VVC received an antimycotic prescription. The three most frequently prescribed drugs were clotrimazole (72%), fluconazole (14%), and nystatin (6%).Conclusion: More than 5% of women were diagnosed with VVC and the majority of them received an appropriate prescription.

Epidemiology and antifungal susceptibility patterns of Candida isolates from Greek women with vulvovaginal candidiasis

“…In particular, factors predisposing to VVC include pregnancy, hormone replacement, uncontrolled diabetes mellitus, long‐term broad‐spectrum antibiotic treatment, immunosuppression, contraceptives usage, and also poor personal hygiene and some sexual and clothing habits . In Europe, VVC is one of the most common causes of vaginitis, and in the United States, it is the second most frequent cause of infection after bacterial vaginosis . It has been estimated that 75% of all women will experience at least one episode of VVC in their lives.…”

Características clínicas de vulvovaginitis por cándida albicans en mujeres en edad reproductiva

“…Con respecto al uso de anticonceptivos, en nuestro estudio tuvo mayor prevalencia la depoprovera y anticonceptivos orales combinados que son de composición hormonal que coinciden con reportes de Jacob L y col 16 quienes encuentran que el uso de anticonceptivos orales tuvo mayor prevalencia entre las mujeres con candidiasis vulvovaginal; así como lo señalado por Huaranga M y col 5 y Herrera Y 17 , que el uso de AOC es un factor de riesgo asociado a CVV. Así como lo señalado por la IIkit M y col 4 que el uso de anticonceptivos orales como el factor de riesgo para el desarrollo de esta afección.…”

Epidemiology and etiology of vulvovaginal candidiasis in Spanish and immigrants’ women in Fuenlabrada (Madrid)

“…Las diferencias entre distintos países y entre los diferentes estudios dentro del mismo país, probablemente se relacionan con criterios de selección de las pacientes en los estudios, la presencia de gestación o diabetes, la toma de antibióticos, o diferentes hábitos socioculturales (uso de anticonceptivos orales, uso de medios de barrera y espermicidas, actividad sexual, hábitos sexuales, higiene personal, etc...) [1,2,19,[22][23][24].…”