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The effect of antifungal treatment on the vaginal flora of women with vulvo-vaginal yeast infection with or without bacterial vaginosis

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Abstract

Antibacterial therapy may enhance the risk of symptomatic vulvo-vaginal candidosis in susceptible women. We addressed the question whether oral antifungal treatment for vulvo-vaginal candidosis also influences the bacterial vaginal microflora. One hundred and forty-two patients with a culture-proven acute episode of recurrent vulvo-vaginal candidosis (RVC) were treated with fuconazole according to the ReCiDiF regimen (induction dose of 600 mg orally per week followed by 200 mg per week) or with a single dose of 200 mg pramiconazole, a new potent oral triazole. At inclusion, 1 week and 1 month after the end of antifungal treatment, the bacterial microflora was assessed by microscopy of vaginal fluid to detect lactobacillary grades and bacterial vaginosis (BV). The presence of BV was studied in these patients with vulvo-vaginal candidosis after treatment with antifungal medication. At the start of oral antifungal treatment, 6.3% of women with Candida were co-infected with BV. Of the BV-negative women, 10 out of 133 (8%) developed BV after 1 week and after 1 month 8 of them (7%) were still BV-positive. Although no patients received antibacterial treatment at any moment of the study, 6 out of 9 (66%) of the women with Candida and BV at inclusion no longer had BV 1 week after antifungal treatment and 6 out of 7 (86%) lacked BV after 1 month. Treatment with antifungals may have a beneficial effect on women with concurrent BV, but does not prevent BV from occurring in BV-negative women with Candida vaginitis.

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Funding

The statistics and data management were funded by Femicare, a non-profit organization supporting clinical research for women.

Transparency declaration

None of the authors has received any payment for this study or have any conflict of interest. During the original two studies on which these data were based, Femicare received an educational grant from Pfizer and from Barrier, and Prof. Borgers has received consultancy fees from Barrier. J. Ausma was employed by Barrier during the one of the trials.

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Authors and Affiliations

  1. Clinical Research Center Femicare, Lombardstraat 28, 3300, Tienen, Belgium

    G. Donders & G. Bellen

  2. University Hospital Gasthuisberg, Leuven, Belgium

    G. Donders

  3. Barrier Therapeutics NV, Cipalstraat 3, Geel, Belgium

    J. Ausma

  4. General Hospital St. Dympna Geel, Maastricht University, Geel, Belgium

    L. Verguts & J. Vaneldere

  5. General Hospital Genk, Maastricht University, Genk, Belgium

    P. Hinoul

  6. Department of Molecular Cell Biology, Maastricht University, Maastricht, The Netherlands

    M. Borgers

  7. Barrier Therapeutics Inc, 600 College Road East, Suite 3200, Princeton, NJ, 08540, USA

    M. Borgers

  8. Private Practice in Gynaecology, Turnhout, Belgium

    D. Janssens

Authors
  1. G. Donders
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  2. G. Bellen
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  3. J. Ausma
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  4. L. Verguts
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  5. J. Vaneldere
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  6. P. Hinoul
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  7. M. Borgers
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  8. D. Janssens
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Correspondence to G. Donders.

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Donders, G., Bellen, G., Ausma, J. et al. The effect of antifungal treatment on the vaginal flora of women with vulvo-vaginal yeast infection with or without bacterial vaginosis. Eur J Clin Microbiol Infect Dis 30, 59–63 (2011). https://doi.org/10.1007/s10096-010-1052-6

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  • DOI: https://doi.org/10.1007/s10096-010-1052-6

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