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Vaginal Nystatin Versus Oral Fluconazole for the Treatment for Recurrent Vulvovaginal Candidiasis

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Abstract

Recurrent vulvovaginal candidiasis (RVVC) is a common condition that can physically and psychologically impact patients. We compared the efficacy and safety of vaginal nystatin suppositories for 14 days each month versus standard oral fluconazole regimens for the treatment for RVVC. Patients (n = 293) were enrolled in the study from April 2010 to September 2013. After the initial therapy, the mycological cure rates were 78.3 % (119/152) and 73.8 % (104/141) in the nystatin group and fluconazole group, respectively (95 % CI, 0.749–2.197, p > 0.05). The mycological cure rates at the end of maintenance therapy were 80.7 % (96/119) and 72.7 % (72/99) in the two groups, respectively (95 % CI, 0.954–3.293, p > 0.05).The mycological cure rates at the end without treatment for 6 months were 81.25 % (78/96) and 82.19 % (60/73) in the two groups, respectively (95 % CI, 0.427–2.066, p > 0.05). The mycological cure rates of RVVC caused by C. albicans were 84.0 % (89/106) and 81.8 % (99/121) in the two groups, respectively. The mycological cure rates of RVVC caused by C. glabrata were 64.3 % (27/42) and 12.5 % (2/16) in the two groups, respectively. The initial and 6-month maintenance therapy were successful in five of the nine patients in the nystatin group with RVVC caused by fluconazole-resistant Candida, whereas in the fluconazole group, initial therapy failed in all patients with RVVC caused by fluconazole-resistant Candida (n = 7). We conclude that both fluconazole and nystatin therapies are effective in treating RVVC. Nystatin may also be effective for the treatment for RVVC caused by C. glabrata or fluconazole-resistant Candida.

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Acknowledgments

This research was supported by a Shenzhen Science and Technology Grant 201201001.

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The authors have no conflict of interests to declare.

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Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, Peking University Shenzhen Hospital, Shenzhen, 518036, China

    Shangrong Fan, Cong Wu, Lixuan Xu & Jianling Li

  2. Shenzhen Key Laboratory of Gynecological Diagnostic Technology Research, Shenzhen, 518036, China

    Shangrong Fan

  3. Department of Laboratory Science, Peking University Shenzhen Hospital, Shenzhen, 518036, China

    Xiaoping Liu

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  1. Shangrong Fan
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  2. Xiaoping Liu
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  3. Cong Wu
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  4. Lixuan Xu
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Correspondence to Shangrong Fan.

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Fan, S., Liu, X., Wu, C. et al. Vaginal Nystatin Versus Oral Fluconazole for the Treatment for Recurrent Vulvovaginal Candidiasis. Mycopathologia 179, 95–101 (2015). https://doi.org/10.1007/s11046-014-9827-4

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  • DOI: https://doi.org/10.1007/s11046-014-9827-4

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