Management of chronic vulvovaginal candidiasis: A long term retrospective study

Abstract

Background: Chronic vulvovaginal candidiasis (CVVC) is described by a vulvovaginitis that is chronic in nature, and is associated with the presence of Candida in the vagina.(Fischer 2012, Hong, Dixit et al. 2013) Limited data is available on the treatment for CVVC and the subsequent long-term outcomes of treatment regimes for CVVC. This retrospective case series aims to explore the long-term outcomes of a regimen used in the treatment of CVVC. Methods: Retrospective case series conducted over 1 year from data obtained from a private vulvar dermatology outpatient clinic. Data from 200 patients satisfying presumptive or diagnostic criteria for CVVC were collected from a database, including drugs, doses, induction and maintenance treatment regimes, results and adverse effects. Results: Data for 200 patients with CVVC was collected from the private outpatient dermatology clinic database. All patients achieved a clinical response to an oral induction daily fluconazole regime within 12 weeks. 96.5% of patients remained on oral fluconazole for maintenance treatment and the other 3.5% changed to other antifungals due to adverse effects. 98.0% of the study cohort remains on treatment with an oral antifungal for symptom suppression with the longest follow up duration of eight years. Conclusion: An effective dosing regime for this subset of women with CVVC was an induction regime of oral fluconazole commencing with 50-100 mg daily for 12 weeks followed by a maintenance dose of fluconazole 50 mg, ranging between an ongoing requirement of 50 mg daily to 50 mg as needed. Adverse effects in this cohort were minimal.