Document Detail

Treatment of recurrent vulvovaginal candidiasis.
MedLine Citation:
PMID:  10865926     Owner:  NLM     Status:  MEDLINE    
Vulvovaginal candidiasis is considered recurrent when at least four specific episodes occur in one year or at least three episodes unrelated to antibiotic therapy occur within one year. Although greater than 50 percent of women more than 25 years of age develop vulvovaginal candidiasis at some time, fewer than 5 percent of these women experience recurrences. Clinical evaluation of recurrent episodes is essential. Patients who self-diagnose may miss other causes or concurrent infections. Known etiologies of recurrent vulvovaginal candidiasis include treatment-resistant Candida species other than Candida albicans, frequent antibiotic therapy, contraceptive use, compromise of the immune system, sexual activity and hyperglycemia. If microscopic examination of vaginal secretions in a potassium hydroxide preparation is negative but clinical suspicion is high, fungal cultures should be obtained. After the acute episode has been treated, subsequent prophylaxis (maintenance therapy) is important. Because many patients experience recurrences once prophylaxis is discontinued, long-term therapy may be warranted. Patients are more likely to comply when antifungal therapy is administered orally, but oral treatment carries a greater potential for systemic toxicity and drug interactions.
E N Ringdahl
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  American family physician     Volume:  61     ISSN:  0002-838X     ISO Abbreviation:  Am Fam Physician     Publication Date:  2000 Jun 
Date Detail:
Created Date:  2000-07-12     Completed Date:  2000-07-12     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  1272646     Medline TA:  Am Fam Physician     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  3306-12, 3317     Citation Subset:  AIM; IM    
Department of Family and Community Medicine, University of Missouri-Columbia School of Medicine, 65212, USA.
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MeSH Terms
Antifungal Agents / therapeutic use*
Boric Acids / therapeutic use
Candidiasis, Vulvovaginal / diagnosis,  drug therapy*,  etiology,  prevention & control
Clotrimazole / therapeutic use
Drug Interactions
Fluconazole / therapeutic use
Ketoconazole / therapeutic use
Patient Education as Topic
Risk Factors
Teaching Materials
Time Factors
Triazoles / therapeutic use
Reg. No./Substance:
0/Antifungal Agents; 0/Boric Acids; 0/Triazoles; 11113-50-1/boric acid; 23593-75-1/Clotrimazole; 65277-42-1/Ketoconazole; 67915-31-5/terconazole; 86386-73-4/Fluconazole

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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