Department of Obstetrics and Gynecology, Biruni University School of Medicine, Istanbul, Turkey; Department of Obstetrics and Gynecology, Medicana International Istanbul Hospital, Istanbul, Turkey.
Department of Microbiology, Golcuk Necati Celik Public Hospital, Kocaeli, Turkey.
J Mycol Med. 2021 Sep;31(3):101138. doi: 10.1016/j.mycmed.2021.101138. Epub 2021 May 7.
Vulvovaginal candidiasis (VVC) is one of the three most common vaginal infections of women. Our goal is to check which treatment method (vaginal or vaginal combined with oral) is more effective for each trimester to treat VVC.
A retrospective analysis was performed and vaginal culture results after treatment of 61 pregnant women who were treated with vaginal or vaginal plus oral antifungals, were collected. Women were grouped according to the method were treated and the trimester they were in. Patients who had used vaginal 750 mg metronidazole + 200 mg miconazole nitrate were determined as the vaginal treatment group. Patients who had used vaginal 750 mg metronidazole + 200 mg miconazole nitrate and oral 150 mg fluconazole were determined as the vaginal plus oral treatment group.
When the patients were grouped according to treatment method, there were no significant differences in demographic characteristics except previous antibiotic use. Previous antibiotic use was significantly higher in the vaginal treatment group (p<0.05). There were no statistically significant differences between the recurrence of VVC in the vaginal and vaginal plus oral treatment group in the first, second, and third trimesters.
The results of the study showed that the efficiency of the vaginal treatment was the same as the vaginal plus oral treatment in all three trimesters in the aspect of VVC recurrence. Local treatment of VVC has several advantageous features when compared with oral therapy including a low rate of adverse events, safe utilization during pregnancy, and breastfeeding.
外阴阴道念珠菌病(VVC)是女性最常见的三种阴道感染之一。我们的目标是检查哪种治疗方法(阴道或阴道联合口服)在每个孕期对治疗 VVC 更有效。
对 61 名接受阴道或阴道联合口服抗真菌药物治疗的孕妇的阴道培养结果进行回顾性分析。根据治疗方法和孕期将女性分组。使用阴道 750mg 甲硝唑+200mg 硝酸咪康唑的患者被确定为阴道治疗组。使用阴道 750mg 甲硝唑+200mg 硝酸咪康唑和口服 150mg 氟康唑的患者被确定为阴道联合口服治疗组。
当根据治疗方法对患者进行分组时,除了既往使用抗生素外,人口统计学特征没有显著差异。既往抗生素使用在阴道治疗组显著更高(p<0.05)。在第一、第二和第三孕期,阴道和阴道联合口服治疗组 VVC 复发率之间没有统计学差异。
研究结果表明,在 VVC 复发方面,阴道治疗的疗效与阴道联合口服治疗在所有三个孕期相同。与口服治疗相比,局部治疗 VVC 具有几个优势,包括不良反应发生率低、在妊娠和哺乳期安全使用。