Treatment for recurrent vulvovaginal candidiasis (thrush)

Cooke, Georga; Watson, Cathy; Deckx, Laura; Pirotta, Marie; Smith, Jane; Driel, Mieke van

doi:10.1002/14651858.cd009151.pub2

Cited by 24 publications

(19 citation statements)

References 72 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Another important issue is selecting the optimal treatment approach in females with recurrent VVC and diabetes, especially since many author groups recommend routine prophylactic administration of antimicrobial drugs in preventing candidiasis when faced with uncontrolled diabetes[ 6 , 21 ]. The best approach is still a matter of debate, as even a recent and comprehensive Cochrane review on different pharmacological and non-pharmacological treatment modalities highlighted that more research is necessary to ascertain the optimal medication choices as well as dose and frequency for females with diabetes[ 66 ].…”

Section: Types Of Urogenital Candidiasis In Patients With Diabetesmentioning

confidence: 99%

Growing importance of urogenital candidiasis in individuals with diabetes: A narrative review

Talapko¹,

Meštrović²,

Škrlec³

2022

World J Diabetes

View full text Add to dashboard Cite

Both diabetes and fungal infections contribute significantly to the global disease burden, with increasing trends seen in most developed and developing countries during recent decades. This is reflected in urogenital infections caused by Candida species that are becoming ever more pervasive in diabetic patients, particularly those that present with unsatisfactory glycemic control. In addition, a relatively new group of anti-hyperglycemic drugs, known as sodium glucose cotransporter 2 inhibitors, has been linked with an increased risk for colonization of the urogenital region with Candida spp., which can subsequently lead to an infectious process. In this review paper, we have highlighted notable virulence factors of Candida species (with an emphasis on Candida albicans ) and shown how the interplay of many pathophysiological factors can give rise to vulvovaginal candidiasis, potentially complicated with recurrences and dire pregnancy outcomes. We have also addressed an increased risk of candiduria and urinary tract infections caused by species of Candida in females and males with diabetes, further highlighting possible complications such as emphysematous cystitis as well as the risk for the development of balanitis and balanoposthitis in (primarily uncircumcised) males. With a steadily increasing global burden of diabetes, urogenital mycotic infections will undoubtedly become more prevalent in the future; hence, there is a need for an evidence-based approach from both clinical and public health perspectives.

show abstract

Section: Types Of Urogenital Candidiasis In Patients With Diabetesmentioning

confidence: 99%

Growing importance of urogenital candidiasis in individuals with diabetes: A narrative review

Talapko¹,

Meštrović²,

Škrlec³

2022

World J Diabetes

View full text Add to dashboard Cite

show abstract

“…It is estimated that 15% of VC cases progress to RVC, resulting in 138 million women per year suffering from this disease [ 1 , 7 , 8 ]. Due to the limited and unclear information available on the treatment of RVC, extensive research is needed on new dosage forms, especially nanoforms, as well as drugs with higher antifungal activity and lower risks of side effects, e.g., ibrexafungerp and oteseconazole [ 9 , 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Nanoemulsion Loaded with Clotrimazole Based on Rapeseed Oil for Potential Vaginal Application—Development, Initial Assessment, and Pilot Release Studies

et al. 2023

View full text Add to dashboard Cite

Vaginal candidiasis (VC) is an emerging global hardly treated health issue affecting millions of women worldwide. In this study, the nanoemulsion consisting of clotrimazole (CLT), rapeseed oil, Pluronic F-68, Span 80, PEG 200, and lactic acid was prepared using high-speed and high-pressure homogenization. Yielded formulations were characterized by an average droplet size of 52–56 nm, homogenous size distribution by volume, and a polydispersity index (PDI) < 0.2. The osmolality of nanoemulsions (NEs) fulfilled the recommendations of the WHO advisory note. NEs were stable throughout 28 weeks of storage. The stationary and dynamic (USP apparatus IV) pilot study of the changes of free CLT over time for NEs, as well as market cream and CLT suspension as references, were conducted. Test results of the changes in the amount of free CLT released from the encapsulated form were not coherent; in the stationary method, NEs yielded up to 27% of the released CLT dose within 5 h, while in the USP apparatus IV method, NEs released up to 10% of the CLT dose. NEs are promising carriers for vaginal drug delivery in the treatment of VC; however, further development of the final dosage form and harmonized release or dissolution testing protocols are needed.

show abstract

“…Topical or oral antifungal azole-based formulations are widely recommended (Pappas et al, 2015;Sherrard et al, 2018;Farr et al, 2021a). Compared with placebo or no therapy, treatment with oral or topical antifungals reduces symptomatic clinical recurrences (Cooke et al, 2022). Although episodic fluconazole treatment is at times sufficient to prevent frequent recurrences, long-term antifungal prophylaxis with a maintenance regimen is often necessary (Sobel and Sobel, 2018).…”

Section: Introductionmentioning

confidence: 99%

“…Although episodic fluconazole treatment is at times sufficient to prevent frequent recurrences, long-term antifungal prophylaxis with a maintenance regimen is often necessary (Sobel and Sobel, 2018). However, differences between treatment options (e.g., different doses and durations) that may explain variations in their efficacy or effectiveness remain imprecisely defined (Cooke et al, 2022).…”

Section: Introductionmentioning

confidence: 99%

Management of recurrent vulvovaginal candidosis: Narrative review of the literature and European expert panel opinion

Donders

Sziller

Paavonen

et al. 2022

Front. Cell. Infect. Microbiol.

View full text Add to dashboard Cite

Recurrent vulvovaginal candidosis (RVVC) is a chronic, difficult to treat vaginal infection, caused by Candida species, which affects women of all ages and ethnic and social background. A long-term prophylactic maintenance regimen with antifungals is often necessary. In most clinical practice guidelines, oral fluconazole is recommended as the first-line treatment. Although clinical resistance to antifungal agents remains rare, overexposure to azoles may increase the development of fluconazole-resistant C. albicans strains. In addition, non-albicans Candida species are frequently dose-dependent susceptible or resistant to fluconazole and other azoles, and their prevalence is rising. Available therapeutic options to treat such fluconazole-resistant C. albicans and low susceptibility non-albicans strains are limited. Ten experts from different European countries discussed problematic issues of current RVVC diagnosis and treatment in two audiotaped online sessions and two electronic follow-up rounds. A total of 340 statements were transcribed, summarized, and compared with published evidence. The profile of patients with RVVC, their care pathways, current therapeutic needs, and potential value of novel drugs were addressed. Correct diagnosis, right treatment choice, and patient education to obtain adherence to therapy regimens are crucial for successful RVVC treatment. As therapeutic options are limited, innovative strategies are required. Well- tolerated and effective new drugs with an optimized mechanism of action are desirable and are discussed. Research into the impact of RVVC and treatments on health-related quality of life and sex life is also needed.

show abstract

Treatment for recurrent vulvovaginal candidiasis (thrush)

Abstract: Treatment for recurrent vulvovaginal candidiasis (thrush) (Review)

Cited by 24 publications

References 72 publications

Growing importance of urogenital candidiasis in individuals with diabetes: A narrative review

Growing importance of urogenital candidiasis in individuals with diabetes: A narrative review

Nanoemulsion Loaded with Clotrimazole Based on Rapeseed Oil for Potential Vaginal Application—Development, Initial Assessment, and Pilot Release Studies

Management of recurrent vulvovaginal candidosis: Narrative review of the literature and European expert panel opinion

Contact Info

Product

Resources

About