Treatment of vulvovaginal candidiasis: a review of the literature

Dovnik, Andraž; Golle, Andrej; Novák, D.; Arko, Darja; Takač, Iztok

doi:10.15570/actaapa.2015.2

Cited by 74 publications

(74 citation statements)

References 28 publications

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“…Vaginitis is a common gynaecologic disorder that is responsible for 10 million office visits to physicians each year. In particular, fungal infection of the vulva and the vagina is estimated to be the second most common cause of inflammation after bacterial vaginosis . About 75% of women during their reproductive age have at least one episode of vulvovaginal candidiasis (VVC) and approximately half of them have two or more episodes.…”

Section: Introductionmentioning

confidence: 99%

Randomised clinical trial in women with Recurrent Vulvovaginal Candidiasis: Efficacy of probiotics and lactoferrin as maintenance treatment

Russo¹,

Superti²,

Karadja

et al. 2019

Mycoses

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Summary Background Vulvovaginal candidiasis (VVC) is a recurrent vaginal condition in childbearing women. Objectives The aim of this study was to assess the efficacy of an oral formulation containing Lactobacillus acidophilus GLA‐14, Lactobacillus rhamnosus HN001 and bovine lactoferrin on symptoms and recurrence of VVC as adjuvant therapy to topical clotrimazole. Patients/Methods Forty‐eight women positive for C. albicans, symptoms of VVC and documented history of recurrences were randomised into 2 groups receiving verum or placebo (2 capsules/day for 5 days followed by 1 capsule/day for additional 10 days) as adjuvant treatment to clotrimazole (induction phase) followed by a maintenance cycle of 6 months (1 capsule/day verum or placebo for 10 consecutive days each month). Symptoms, overall cure rate and recurrence rate were assessed. Results After clotrimazole therapy, a significant improvement of symptoms was shown in both groups. However, only women treated with probiotics and lactoferrin showed a significant improvement of itching and discharge at 3 and 6 months. During the six‐month follow‐up, recurrences were significantly less in the intervention group vs placebo (33.3% vs 91.7% after 3 months and 29.2% vs 100% after 6 months). Conclusions The results show that the investigated lactobacilli mixture in combination with lactoferrin represents a safe and effective adjuvant approach for reducing symptoms and recurrences of RVVC.

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Section: Introductionmentioning

confidence: 99%

Randomised clinical trial in women with Recurrent Vulvovaginal Candidiasis: Efficacy of probiotics and lactoferrin as maintenance treatment

Russo¹,

Superti²,

Karadja

et al. 2019

Mycoses

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“…However, it is difficult to assess the exact incidence of VVC, due to the high rate of indiscriminate use of medicines. Furthermore, the diagnosis is frequently and entirely based on signs and symptoms without any diagnostic tests to confirm, and the treatment depends on whether the infection is complex or simple (BEHZADI et al, 2015, DOVNIK et al, 2015.…”

Section: Introductionmentioning

confidence: 99%

Study of the antifungal potential of (r)-(+)-citronellal and its association with therapeutic agents used in the treatment of vulvovaginal candidiasis

Medeiros¹,

Silva²,

Pérez³

et al. 2017

Biosci. J.

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ABSTRACT:Vulvovaginal candidiasis (VVC) is a common fungal infection that affects healthy women of all ages. At least 75% of women will develop one or more infections once during their lifetime, with 6 to 9% of those individuals developing recurrent infections. In view of this context, this study sought to evaluate the antifungal potential of the isolated (R)-(+)-citronellal [(R)-(+)-CT] and associated to therapeutic agents of clinical importance. The enantiomer was solubilized in tween 80 and dimethylsulfoxide (DMSO). Posteriorly diluted in sterile distilled water up to the concentration of 2048µg/mL. The minimum inhibitory concentration (MIC) of the product was determined by microdilution in RPMI-1640 obtaining dilutions of 1024-4µg/mL. The minimum fungicidal concentration (MFC) was determined by the Sabouraud dextrose agar (SDA) depletion technique from aliquots of 1µL of the MIC, MIC × 2 and MIC × 4. The MIC and the MFC values of (R)-(+)-CT for 90% of the C. albicans strains were 16 and 32µg/mL respectively. In the susceptibility test, C. albicans presented a high resistance to fluconazole and to itraconazole, 12 (92.30%) of the strains. However, for ketoconazole and miconazole the resistance was of 4 (30.76%) and 3 (23.07%) of the strains respectively. In the combination testing of the (R)-(+)-CT with ketoconazole and miconazole, the resistance was completely reverted. For fluconazole and itraconazole, the resistance was reverted in 9 (75%) and 7 (58.33%) of the strains respectively. The (R)-(+)-CT presented fungicide activity with MFC of MIC × 2. When in combination with ketoconazole, fluconazole, itraconazole and miconazole increased the inhibition zones of these antifungal drugs, reducing the resistance against C. albicans.

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“…It has been estimated that approximately 75% of all women will experience at least one episode of VVC during their lifetime, among which 40%-50% will experience a further episode [1] . Moreover, 5%-8% of adult women have symptomatic recurrent VVC (RVVC), which is defined as 4 episodes per year [2] .…”

Section: Introductionmentioning

confidence: 99%

ERG11 mutations associated with azole resistance in Candida albicans isolates from vulvovaginal candidosis patients

Wang

Huang

Zhao

et al. 2015

Asian Pacific Journal of Tropical Biomedicine

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A B S T R A C TObjective: To investigate the azole susceptibility of Candida albicans (C. albicans) from vulvovaginal candidosis patients and to analyze the relationship between ERG11 gene mutations in these isolates and azole resistance. Methods: Three hundred and two clinical isolates of Candida species were collected. Azole susceptibility was tested in vitro in microdilution studies. The ERG11 genes of 17 isolates of C. albicans (2 susceptibles, 5 dose-dependent resistants and 10 resistants) were amplified and sequenced. Results: Of the 302 isolates collected, 70.2% were C. albicans, of which 8.5%, 3.8% and 4.2% were resistant to fluconazole, itraconazole and voriconazole, respectively. In total, 27 missense mutations were detected in ERG11 genes from resistant/susceptible dosedependent isolates. Among them, Y132H, A114S, and Y257H substitutions were most prevalent and were known to cause fluconazole resistance. G464S and F72S also have been proved to cause fluconazole resistance. Two novel substitutions (T285A, S457P) in hotspot regions were identified. Conclusions: Twenty seven mutations in the ERG11 gene were identified in azoleresistant C. albicans isolates, which indicated a possible relation with the increase in resistance to azole drugs and the recurrence of vulvovaginal candidosis. The relationship of two novel substitutions (T285A, S457P) with fluconazole resistance needs to be further verified by site-directed mutagenesis.

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Treatment of vulvovaginal candidiasis: a review of the literature

Cited by 74 publications

References 28 publications

Randomised clinical trial in women with Recurrent Vulvovaginal Candidiasis: Efficacy of probiotics and lactoferrin as maintenance treatment

Randomised clinical trial in women with Recurrent Vulvovaginal Candidiasis: Efficacy of probiotics and lactoferrin as maintenance treatment

Study of the antifungal potential of (r)-(+)-citronellal and its association with therapeutic agents used in the treatment of vulvovaginal candidiasis

ERG11 mutations associated with azole resistance in Candida albicans isolates from vulvovaginal candidosis patients

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