Department of General Practice and Primary Health Care Academic Centre, University of Melbourne, Carlton, Vic., Australia; Gynaecology Assessment Clinic, Royal Women's Hospital, Flemington, Melbourne, Vic., Australia.
BJOG. 2014 Mar;121(4):498-506. doi: 10.1111/1471-0528.12518. Epub 2013 Dec 6.
Garlic is effective against Candida species in vitro, and along with other alternative therapies, is used by women with vulvovaginal candidiasis. The objective of this study was to ascertain whether oral garlic reduced vaginal candida counts during the second half of the menstrual cycle in asymptomatic women colonised with Candida species.
A simple randomised double-blinded controlled trial.
Melbourne, Australia.
Sixty-three asymptomatic women who were culture-positive for Candida species at screening.
Participants were randomised to three garlic tablets or placebo orally, twice daily, for 14 days.
The primary outcome was the proportion of women with colony counts of candida >100 colony-forming units per ml in any given day during the last 7 days before menstruation, defined as a 'case'. Secondary outcomes included the mean quantitative colony counts of candida over 14 days prior to menses.
There was no evidence of a difference between the proportion of cases in the garlic and placebo groups (76 versus 90%; relative risk, RR 0.85; 95% confidence interval, 95% CI 0.67-1.08), in the mean colony counts in both groups (ratio of geometric means of candidal colony counts 0.63; 95% CI 0.39-10.03; P = 0.74), or difference in the number of women reporting abnormal vaginal symptoms during the 2 weeks before menstruation (RR 1.03; 95% CI 0.67-1.58; P = 0.91). The garlic group reported more adverse effects (83% compared 43% in the placebo group; difference in proportions 39%; 95% CI 17-%; P < 0.01).
This study provided data for sample size calculations in future studies on the antifungal effect of garlic, but provided no evidence to inform clinical practice regarding the use of garlic in vaginal candidiasis. Further studies might investigate longer courses or topical formulations.
大蒜在体外对念珠菌属有效，并且与其他替代疗法一起，被患有外阴阴道念珠菌病的女性使用。本研究的目的是确定在无症状的被念珠菌属定植的女性中，口服大蒜是否能在月经周期的后半期降低阴道念珠菌计数。
简单随机双盲对照试验。
澳大利亚墨尔本。
在筛查时培养出念珠菌属阳性的 63 名无症状女性。
参与者随机分为三组，分别口服大蒜片或安慰剂，每日两次，共 14 天。
主要结局是在月经前的最后 7 天内任何一天念珠菌计数>100 个菌落形成单位/毫升的女性比例，定义为“病例”。次要结局包括在月经前 14 天内念珠菌平均定量菌落计数。
大蒜组和安慰剂组病例的比例（76%与 90%；相对风险，RR 0.85；95%置信区间，95%CI 0.67-1.08）、两组的平均菌落计数（念珠菌菌落计数的几何均数比值 0.63；95%CI 0.39-10.03；P=0.74）或在月经前 2 周内报告异常阴道症状的女性人数差异均无统计学意义（RR 1.03；95%CI 0.67-1.58；P=0.91）。大蒜组报告的不良反应更多（83%比安慰剂组的 43%；差异比例 39%；95%CI 17-43%；P<0.01）。
本研究为大蒜抗真菌作用的进一步研究提供了样本量计算数据，但没有为临床实践中使用大蒜治疗阴道念珠菌病提供依据。进一步的研究可能会调查更长的疗程或局部制剂。
