oa SA Pharmaceutical Journal - Recurrent vulvovaginal candidiasis : evidence-based pharmacy practice
Vulvovaginal candidiasis (VVC) is part of a group of infections termed the superficial fungal infections. These can be classified as complicated or uncomplicated, sporadic or recurrent. Some patients are difficult to diagnose, and may not respond to standard therapies. These patients suffer from recurrent or chronic VVC. Recurrent VVC is defined as more than four episodes of VVC within a 12-month period. Patients normally present with a white, cheesy discharge and vulvovaginal itching. Clinical findings (itching or a cheesy discharge) or laboratory tests (potassium hydroxide, Gram stains and vaginal pH) are not sensitive or specific predictors of Candida vaginitis. Treating recurrent VVC requires an aggressive treatment plan using two stages, namely an induction and a maintenance stage. A high incidence of recurrent VVC requires a thorough understanding of the epidemiology and pathophysiology of the condition. Treatment with azole antifungals and nystatin derivatives may provide relief if given for an adequate period of time.
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