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Risk factors for recurrent vulvovaginal candidiasis in women receiving maintenance antifungal therapy: Results of a prospective cohort study

Abstract:

Objective: The purpose of this study was to examine risk factors for symptomatic vulvovaginal candidiasis episodes among women with recurrent vulvovaginal candidiasis (defined as ≥ 4 vulvovaginal candidiasis episodes in 1 year) who were receiving maintenance antifungal therapy. Study design: A prospective study of 65 women aged ≥ 18 years with recurrent vulvovaginal candidiasis who attended vaginitis clinics in Detroit, Mich, and Philadelphia, Pa. Results: The 9-month risk of vulvovaginal candidiasis recurrence was 41.8%. Almost two fifths of the women reported activity limitations because of vulvovaginal candidiasis episodes, most or all of the time. Younger women and those women with a history of bacterial vaginosis were at increased risk of vulvovaginal candidiasis episodes. Behavioral factors that were associated significantly with increasing vulvovaginal candidiasis recurrence ≥ 2- fold included wearing pantyliners or pantyhose and consuming cranberry juice or acidophilus-containing products. Conclusion: The use of pantyliners or pantyhose, consumption of cranberry juice or acidophil-containing products, a history of bacterial vaginosis, and age < 40 years were positively associated with a symptomatic vulvovaginal candidiasis episode. © 2004 Elsevier Inc. All rights reserved.