Current opportunities for treatment and prevention of recurrent vulvovaginitis in reproductive aged women
DOI:
https://doi.org/10.18370/2309-4117.2021.61.77-82Keywords:
recurrent vulvovaginal candidiasis, treatment, CandivacAbstract
Vulvovaginal candidiasis is an urgent medical and social problem, a common reason for women to see a doctor. This disease occurs in women of different ages, which leads to a significant decrease in the quality of life, and to more serious complications in some cases (genitourinary system diseases, miscarriage, vaginal stenosis, etc.).
Research objective. Comprehensive assessment of the effectiveness of treatment and prevention of recurrent vulvovaginal candidiasis (RVVC) with Candivac (contains inactivated microorganisms in the form of frozen lyophilized 4 original strains, which are the most common causative agents of vaginal candidiasis).
Materials and methods. 76 women of reproductive age with RVVC were examined and randomized into 2 groups: the main group consisted of 40 patients who received anti-candidiasis therapy with fluconazole and Candivac; the control group included 36 women who received only the standard fluconazole antifungal regimen. The duration of observation was 12 months.
Criteria for evaluating treatment efficacy were no/reduction of clinical symptoms and changes in the vaginal mucosa, positive dynamics of laboratory tests (with control after 3 and 12 months) from the start of treatment.
Results. Clinical efficacy of treatment (regression of complaints and normalization of objective data) in two groups was observed in the majority of patients. At the same time, clinical efficiency in the main group was 87% and exceeded that in the comparison group (63%), which was accompanied by the normalization of the vaginal microbiocenosis. However, after complex therapy with Candivac a more reliable result was observed, which was accompanied by a significant decrease in the frequency of disease recurrence.
Conclusions. Study showed that Candivac in combination with antifungal therapy and probiotic promotes the elimination of systemic inflammation and the rapid return of normal intravaginal microflora, and reduces the number of RVVC recurrences.
References
- Guideline Development Group. “British Association for Sexual Health and HIV national guideline for the management of vulvovaginal candidiasis.” (2019).
- Mills, B.B. “Vaginitis: beyond the basics.” Obstet Gynecol Clin North Am 44.2 (2017): 159–77.
- Sobel, J.D. “Genital candidiasis.” Medicine 42.7 (2014): 364–8.
- Delaloye, J., Calandra, T. “Invasive candidiasis as a cause of sepsis in the critically ill patient.” Virulence 5.1 (2014): 161–9.
- Koseі, N.V. “Modern principles of treatment of inflammatory diseases of female genital organs.” Reproductive endocrinology 1.9 (2013): 78–85.
- Wаchtler, B., Wilson, D., Haedicke, K., et al. “From attachment to damage: defined genes of Candida albicans mediate adhesion, invasion and damage during interaction with oral epithelial cells.” PLoS One 6 (2011): e17046.
- Zordan, R., Cormack, B. “Adhesins on opportunistic fungal pathogens.” In: Calderone R.A., Clancy C.J., ed. Candida and candidiasis. Washington: ASM Press (2012): 243–59.
- Zhang, Y., Li, W., Chu, M., et al. “The AAA ATPase Vps4 plays important roles in Candida albicans hyphal formation and is inhibited by DBeQ.” Mycopathologia 181.5–6 (2016): 329–39.
- Murciano, C., Moyes, D.L., Runglall, M., et al. “Evaluation of the role of Candida albicans agglutinin-like sequence (Als) proteins in human oral epithelial cell interactions.” PLoS One 7(2012): e33362.
- NAMS of Ukraine. Treatment of changes in the microbiocenosis in women of childbearing age at risk groups for chronic recurrent vulvovaginal candidiasis on the background of chronic inflammatory diseases of genital organs: methodical recommendations / SI "O.M. Lukyanova Institute of Pediatrics, Obstetrics and Gynecology of the NAMS of Ukraine", 2020
- Nobile, C.J., Johnson, A.D. “Candida albicans biofilms and human disease.” Annu Rev Microbiol 69 (2015): 71–92.
- Rane, H.S., Hardison, S., Botelho, C., et al. “Candida albicans VPS4 contributes differentially to epithelial and mucosal pathogenesis.” Virulence 5.8 (2014): 810–8.
- Hong, E., Dixit, S., Fidel, P.L., et al. “Vulvovaginal candidiasis as a chronic disease: diagnostic criteria and definition.” J Low Genit Tract Dis 18.1 (2014): 31–8.
- Nett, J.E., Zarnowski, R., Cabezas-Olcoz, J., et al. “Host contributions to construction of three device-associated Candida biofilms.” Infect Immun 83.12 (2015): 4630–8.
- Fox, E.P., Cowley, E.S., Nobile, C.J., et al. “Anaerobic bacteria grow within Candida albicans biofilms and induce biofilm formation in suspension cultures.” Curr Biol 24.20 (2014): 2411–6.
- Donders, G.G., Bellen, G., Mendling, W. “Management of recurrent vulvovaginal candidosis as a chronic illness.” Gynecol Obstet Invest 70.4 (2010): 306–21.
- Sherrard, J., Donders, G., White, D., Jensen, J.S. “European (IUSTI/WHO) guideline on the management of vaginal discharge.” Int J STD AIDS 22.8 (2011): 421–9.
- Moshfeghy, Z., Tahari, S., Janghorban, R., et al. “Association of sexual function and psychological symptoms including depression, anxiety and stress in women with recurrent vulvovaginal candidiasis.” J Turk Ger Gynecol Assoc 21.2 (2020): 90–6.
- Fukazawa, E.I., Witkin, S.S., Robial, R., et al. “Influence of recurrent vulvovaginal candidiasis on quality of life issues.” Arch Gynecol Obstet 300.3. (2019): 647–50.
- Foxman, B., Muraglia, R., Dietz, J.P., et al. “Prevalence of recurrent vulvovaginal candidiasis in 5 European countries and the United States: results from an internet panel survey.” J Low Genit Tract Dis 17.3 (2013): 340–5.
- Bongomin, F., Gago, S., Oladele, R.O., Denning, D.W. “Global and multi-national prevalence of fungal diseases-estimate precision.” J Fungi (Basel) 3.4 (2017): 57.
- Cavalheiro, M., Teixeira, M.C. “Candida biofilms: threats, challenges, and promising strategies.” Frontiers in medicine 5 (2018): 28.
- Wall, G., Montelongo-Jauregui, D., Bonifacio, B.V., et al. “Candida albicans biofilm growth and dispersal: contributions to pathogenesis.” Curr Opin Microbiol 52 (2019): 1–6.
- Rodríguez-Cerdeira, C., Gregorio, M.C., Molares-Vila, A., et al. “Biofilms and vulvovaginal candidiasis.” Colloids Surf B Biointerfaces 1.174 (2019): 110–25.
- Blostein, F., Levin-Sparenberg, E., Wagner, J., Foxman, B. “Recurrent vulvovaginal candidiasis.” Ann Epidemiol 27.9 (2017): 575–82.
- Rosati, D., Bruno, M., Jaeger, M., et al. “Recurrent vulvovaginal candidiasis: an immunological perspective.” Microorganisms 8.2 (2020): 144.
- Belayneh, M., Sehn, E., Korownyk, C. “Recurrent vulvovaginal candidiasis.” Can Fam Physician 63.6 (2017): 455.
- Naji, S., Diba, K., Yosefzadeh, R., Mansouri, F. “Interspecies differences of candida species causing recurrent vulvovaginal candidiasis in response to fluconazole treatment.” Tehran University Medical Journal TUMS Publications 75.4 (2017): 280–7.
- Rosati, D., Bruno, M., Jaeger, M., et al. “Recurrent vulvovaginal candidiasis: an immunological perspective.” Microorganisms 8.2 (2020): 144.
- Sherry, L., Kean, R., McKloud, E., et al. “Biofilms formed by isolates from recurrent vulvovaginal candidiasis patients are heterogeneous and insensitive to fluconazole.” Antimicrob Agents Chemother 61.9 (2017): e01065–17. DOI: 10.1128/AAC.01065-17
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Н.В. Косей, С.І. Регеда, М.І. Гламазда, Л.А. Васильченко
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.