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[Chronic and recurrent vulvovaginal candidiasis]
1Department of Obstetrics and Gynecology, Juntendo Urayasu Hospital, Juntendo University, 2-1-1 Tomioka Urayasu-si, Chiba 279-0021.
Nihon Ishinkin Gakkai Zasshi = Japanese Journal of Medical Mycology
|October 31, 1998
Summary
Vulvovaginal candidiasis (VVC) affects many women, with recurrences posing treatment challenges. While topical treatments show initial success, recurrent VVC (RVVC) management requires further investigation due to potential drug resistance and side effects.
Area of Science:
- Mycology
- Infectious Diseases
- Women's Health
Context:
- Vaginal candidiasis (VVC) is common, affecting 15-30% of women.
- Diagnosis requires Candida spp. isolation and symptomatic evidence.
- Topical treatments in Japan offer 80-90% initial cure rates for VVC.
Purpose:
- To review the challenges in diagnosing and treating recurrent vulvovaginal candidiasis (RVVC).
- To discuss factors contributing to RVVC, including reinfection and host factors.
- To evaluate oral azole therapies for RVVC, considering efficacy and resistance.
Summary:
- Recurrent VVC (RVVC) affects 7-34% of initially cured patients, necessitating effective long-term strategies.
- Oral ketoconazole is effective but limited by side effects; fluconazole and itraconazole are alternatives.
- Emergence of fluconazole-resistant Candida strains during long-term treatment is a concern.
Impact:
- Highlights the need for optimal treatment strategies for RVVC.
- Informs clinical practice regarding the management of difficult-to-treat VVC cases.
- Underscores the importance of monitoring for antifungal resistance in RVVC treatment.