Skip to main content

Advertisement

SpringerLink
Log in

Fluconazole Prophylaxis in Prevention of Symptomatic Candida Vaginitis

  • Female Genital Tract Infections (J Sobel, Section Editor)
  • Published:
Current Infectious Disease Reports Aims and scope Submit manuscript

Abstract

Due to broad spectrum susceptibility of Candida species to fluconazole, its convenience as an oral agent, and predictable patient tolerance and safety, current practice guidelines recommend the use of long-term suppression regimens of fluconazole as prophylaxis for recurrent vulvovaginal candidiasis (RVVC), as well as in abbreviated doses when known trigger factors emerge and inevitable symptomatic episodes are predictable. However, recent concerns of fluconazole-resistant Candida albicans strains may impact fluconazole use, particularly, concerns of overuse. This literature review discusses current recommendations for prophylaxis of vulvovaginal candidiasis with fluconazole.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Sobel JD, Faro S, Force RW, Foxman B, Ledger WJ, Nyirjesy PR, et al. Vulvovaginal candidiasis: epidemiologic, diagnostic, and therapeutic considerations. Am J Obstet Gynecol. 1998;178(2):203–11.

    Article  CAS  Google Scholar 

  2. Bitew, A., & Abebaw, Y. Vulvovaginal candidiasis: species distribution of Candida and their antifungal susceptibility pattern. BMC Women’s Health, 18(1) (2018)., N.PAG. https://doi-org.proxy1.lib.tju.edu/10.1186/s12905-018-0607-z

  3. Yan, L., Wang, X., Seyedmousavi, S., Yuan, J., Abulize, P., Pan, W., . . . Deng, S. (2019). Antifungal susceptibility profile of Candida albicans isolated from vulvovaginal candidiasis in Xinjiang Province of China. Mycopathologia,1-10. doi:https://doi.org/10.1007/s11046-018-0305-2.

    Article  CAS  Google Scholar 

  4. Workowski, Kimberly. “Sexually transmitted diseases treatment guidelines, 2015.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 5 June 2015, https://www.cdc.gov/mmwr/preview/mmwrhtml/rr6403a1.htm.

  5. Yano, J., Fidel, P. L., Fidel, P. L., Jr, Noverr, M. C., Sobel, J. D., Nyirjesy, P., … Yu, Q. (2019). Current patient perspectives of vulvovaginal candidiasis: incidence, symptoms, management and post-treatment outcomes. BMC Women’s Health, 19(1), N.PAG. https://doi-org.proxy1.lib.tju.edu/10.1186/s12905-019-0748-8

  6. Marchaim D, Lemanek L, Bheemreddy S, Kaye KS, Sobel JD. (2012). Fluconazole-resistant candida albicans vulvovaginitis. Obstet Gynecol. 2012 Dec;120(6):1407-14. http://10.1097/AOG.0b013e31827307b2.

    Article  CAS  Google Scholar 

  7. Sobel JD, Wiesenfeld HC, Martens M, Danna P, Hooton TM, Rompalo A, et al. Maintenance fluconazole therapy for recurrent vulvovaginal candidiasis. N Engl J Med. 2004;351(9):876–83.

  8. Donders G, Bellen G, Bytterbier G, Verguts L, Hinoul P, Walckers R, et al. Individualized decreasing maintenance fluconazole regimen for recurrent vulvovaginal candidiasis (ReCi-DiF trial). Am J Obstet Gynecol. 2008;199:613–9.

    Article  Google Scholar 

  9. Sobel, Jack D. “Candida vulvovaginitis: treatment.” UpToDate, UpToDate, 6 Mar. 2019, https://www.uptodate.com/contents/candida-vulvovaginitis-treatment?search=fluconazole and antibiotics&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H2855685582.

  10. Bérard A, Sheehy O, Zhao J-P, Gorgui J, Bernatsky S, de Moura CS, et al. Associations between low- and high-dose oral fluconazole and pregnancy outcomes: 3 nested case-control studies. CMAJ: Canadian Medical Association Journal. 2019;191(7):E179–87. https://doi-org.proxy1.lib.tju.edu/10.1503/cmaj.180963.

    Article  Google Scholar 

  11. Sobel JD, Ohmit SE, Schuman P, Klein RS, Mayer K, Duerr A, Vazquez JA, Rampalo A, HIV Epidemiology Research Study (HERS) Group (2001). The evolution of Candida spp. and fluconazole susceptibility among oral and vaginal isolates recovered from human immunodeficiency virus (HIV)-seropositive and at-risk HIV-seronegative women. J Infect Dis 2001;183:286–293.

    Article  CAS  Google Scholar 

  12. Maraki S, Mavromanolaki VE, Stafylaki D, Nioti E, Hamilos G, Kasimati A. Epidemiology and antifungal susceptibility patterns of Candida isolates from Greek women with vulvovaginal candidiasis. Mycoses. 2019. https://doi.org/10.1111/myc.12946.

    Article  CAS  Google Scholar 

  13. Sobel JD, Chaim W, Nagappan V, Leaman D (2003) Treatment of vaginitis caused by Candida glabrata: use of topical boric acid and flucytosine. Am J Obstet Gynecol 2003 Nov;189(5):1297–1300.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Thomas Jefferson University, Philadelphia, PA, USA

    Kannika Story & Ryan Sobel

Authors
  1. Kannika Story
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ryan Sobel
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kannika Story.

Ethics declarations

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.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Female Genital Tract Infections

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Story, K., Sobel, R. Fluconazole Prophylaxis in Prevention of Symptomatic Candida Vaginitis. Curr Infect Dis Rep 22, 2 (2020). https://doi.org/10.1007/s11908-020-0712-7

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11908-020-0712-7

Keywords

Search

Navigation