Treatment of recurrent vaginal candidiasis

In recurrent vulvovaginal candidiasis, predisposing factors should be eliminated wherever possible. Reduction of the gastrointestinal yeast flora by oral antimycotic treatment does not prevent recurrences. Perianal application of antifungal cream might be an alternative in preventing reinfection from the rectum. Venereal spread of yeasts does not seem to be an important factor, and partner treatment does not significantly alter treatment results. Traditionally, prolonged treatment periods are recommended to prevent recurrences. Patient compliance may then become a factor limiting efficacy. One-dose treatment has been shown to give results that compare favorably with traditional treatment schedules. Results in recurrent cases were comparable with those in primary infections. Thus one-dose treatment could be an acceptable alternative to longer treatment periods in schedules for treatment of recurrent cases. Intermittent prophylactic one-dose application appears to be a promising method of reducing recurrences.