Recurrent vaginal thrush should be treated more aggressively

An investigation into the pathogenesis of vulvo-vaginal candidosis 2001; 77:179-183

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Women who suffer recurrent vaginal thrush should use more prolonged courses of antifungal treatment initially to increase the chances of complete eradication of the yeast, finds a study in Sexually Transmitted Infections.

Over 120 women attending the genitourinary clinic with signs and symptoms of vaginal thrush were included in the study. Swabs were taken from each woman, together with a sterile vaginal wash. Antifungal treatment was also given and the women were asked to return after 1, 4, and 12 weeks, or if their symptoms recurred.

A total of 47 women completed the study, either returning for four visits or suffering a recurrence during the study period. Of the 22 women who experienced recurrence, the same yeast strain was responsible for the initial and recurrent episode in 17 women. None of the women were resistant to the antifungal treatment.

These findings have important implications for the treatment of women with recurrent symptoms, say the authors. As antifungal resistance does not seem to be a problem in the general population, it may be appropriate for these women to use more prolonged courses of antifungal treatment in order to increase the chances of complete eradication of yeasts.

They suggest one possible approach is an extended course of oral antifungals initially, followed by regular preventative treatment, say once or twice monthly, to prevent further recurrences.

Contact:

Dr Maureen Reynolds, Department of Genito-urinary Medicine, Leeds Student Medical Practice, Leeds, UK

Tel: +44 (0)113 295 4488