Vulvovaginitis Caused by Candida Species Following Antibiotic Exposure
Purpose of Review
Goal was to review epidemiology, pathophysiology, and prevention of post-antibiotic Candida vulvovaginitis (VVC).
Antibacterial therapy, whether systemic or locally applied to the vagina, represents the single most frequent and predictable cause or triggering mechanism of symptomatic vulvovaginal candidiasis (VVC). Such initiating mechanisms may precipitate sporadic or recurrent episodes of VVC. In spite of this widely recognized association, the exact mechanism whereby antibiotics of all classes cause acute exacerbation of symptomatic vaginal disease remains largely unstudied and therefore largely unknown. Pathophysiology is hypothesized to be reduction or alteration of vaginal microbiome restraints of yeast colonization, proliferation, and expression of virulence characteristics.
The predictable link between antibiotic use and post-antibiotic VVC affords practitioners an opportunity for timely intervention using selective, convenient antimycotics usually drugs but possibly probiotic measures. Indications and limitation of these steps are discussed.
KeywordsVulvovaginitis Antibiotics Candidiasis Candida species
Compliance with Ethical Standards
Conflict of Interest
All authors declare no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
- 4.lj C. Vaginal moniliasis after tetracycline therapy: the effects of amphotericin B. Am J Obstet Gynecol. 1964;90:374–8.Google Scholar
- 13.Pirotta MV, Gunn JM, Chondros P. “Not thrush again!” Women’s experience of post-antibiotic vulvovaginitis. General Practice In Action. 2003;179:43–6.Google Scholar
- 24.Huppert M, MacPherson DA, Cazin J. Pathogenesis of Candida Albicans infection following antibiotic therapy. Department of Bacteriology and Immunology, University of North Carolina School of Medicine. 1952;65:171–6.Google Scholar