Vulvovaginitis: the role of patient compliance in treatment success

Vulvovaginitis caused by Candida organisms accounts for a large number of annual office visits to physicians, often for recurrent infection. Despite the availability of many effective antifungal preparations, treatment failures continue to occur because of poor compliance with therapy. Several factors may foster noncompliance. Those involving the patient include denial of illness, misconceptions regarding the nature of the infection or its treatment, a misunderstanding of symptomatic relief versus microbiologic cure, dislike of the dosage form, nonsupport of the sexual consort, or intolerance of side effects. The cost of treatment, inconvenient dosage form, and prolonged duration of therapy may also contribute to noncompliance. This article offers suggestions for optimizing compliance and successful treatment. Two perceived means to this end are improved patient education and the use of short-term therapy in convenient dosage form.