Is non-response to fluconazole maintenance therapy for recurrent Candida vaginitis related to sensitization to atopic reactions?

PROBLEM

Is sensitization to atopic reaction related to treatment response of recurrent Candida vulvovaginal (RVVC)?

METHOD OF THE STUDY

Analysis of ReCiDiF trial data of optimal (OR) and non-responders (NR) to fluconazole maintenance treatment, to explore medical history, physical status, family history, and vaginal immune response for potential sensitization to atopic reaction.

RESULTS

Sociodemographic characteristics of 33 NR women were not different from 38 OR. NR had received higher number of different treatments (mean difference 1.6 different treatments (95% CI: 0.20-2.97), P = .03) and had more episodes of disease (P < .05). Multivariate regression analysis showed that family history of atopy (OR: 4.9, CI 95%: 1.1-22.2), duration of symptoms (OR: 1.2, CI 95%: 1.02-1.5), and vulvar excoriation (OR: 3.6, CI 95%: 1.4-9.3) were related to non-response. Vulvar excoriation at entry was the only statistically significant predictive factor for non-response in multivariate analysis with specificity 77.8% and sensitivity 51.6%.

CONCLUSION

Women with RVVC with vulvar excoriation, longer duration of disease, and family history of atopic disease are at increased risk not to respond to maintenance fluconazole treatment.