Related Experiment Video
Updated: Jul 14, 2026
Protocols for Vaginal Inoculation and Sample Collection in the Experimental Mouse Model of Candida vaginitis
Published on: December 8, 2011
Maintenance pharmacological therapy of recurrent vulvovaginal candidiasis. A Bayesian network meta-analysis of
Barbara Gardella1, Chiara Cassani1, Mattia Dominoni1
1Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy; Department of Obstetrics and Gynecology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Objective:
Several topical and oral drugs are available for maintenance therapy of recurrent vulvovaginal candidiasis (RVVC)(≥ 3 episodes of symptomatic Candida infection per year). The study aimed to assess the risk of early (24 weeks) and late (48-52 weeks) clinical and mycological recurrences associated with oral/topical pharmacological maintenance therapy of RVVC.
Methods:
Search strategy: PubMed, EMBASE, Cochrane Library, OVID and clinical trials registers,from inception until January 2024.
Selection Criteria:
Blinded and unblinded randomized studies of pharmacological prevention of RVVC recurrences during active treatment and after discontinuation of therapy.
Data Collection And Analysis:
Risk of bias, indirectness, imprecision, heterogeneity and incoherence of the network were evaluated by a semi-automated software.Bayesian network meta-analysis was used to evaluate effects of interventions on outcomes,league table and ranking of effects.
Results:
The network included 17 studies with 2304 women for early and 2179 for late recurrences. During active treatment weekly oral oteseconazole (OR = 0.05,95 %CI = 0.02-0.12, moderate confidence),weekly oral fluconazole/itraconazole (OR = 0.12,95 %CI = 0.052-0.35,moderate confidence) and weekly topical clotrimazole (OR = 0.087,95 %CI = 0.018-0.48,moderate confidence) were associated with a significant reduction in RVVC recurrence risk compared to placebo/untreated subjects.Weekly use of fluconazole/itraconazole (OR = 0.44,95 %CI = 0.24-0.80,moderate confidence) and monthly topical treatment (OR = 0.34,95 %CI = 0.18-0.66,moderate confidence) maintained efficacy after discontinuation of therapy (48-52 weeks). Weekly oteseconazole was significantly more effective in reducing the occurrence of late clinical (OR = 0.065,95 %CI = 0.036-0.11,moderate confidence) and mycological (OR = 0.073,95 %CI = 0.044-0.12,moderate confidence) RVVC recurrences than all other types of treatment tested.
Conclusions:
Weekly maintenance therapy with oral fluconazole/itraconazole,oteseconazole, or topical clotrimazole was equally effective in preventing early RVVC recurrence.After therapy discontinuation, oteseconazole outperformed all other oral or topical regimens, lowering RVVC clinical and mycological recurrence rates by more than 90%.
Related Concept Videos
01:15Impact of Pharmacokinetic–Pharmacodynamic Models: Regulatory Decisions
01:30Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care
01:28Antimicrobial Effectiveness
01:20Candidiasis
01:18Trichomoniasis
01:15Antifungal Agents