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Probiotics for vulvovaginal candidiasis in non-pregnant women

  1. Huan Yu Xie1,
  2. Dan Feng2,
  3. Dong Mei Wei2,
  4. Hui Chen2,
  5. Ling Mei2,
  6. Xun Wang2,
  7. Fang Fang2,*

Editorial Group: Cochrane STI Group

Published Online: 30 APR 2013

DOI: 10.1002/14651858.CD010496


How to Cite

Xie HY, Feng D, Wei DM, Chen H, Mei L, Wang X, Fang F. Probiotics for vulvovaginal candidiasis in non-pregnant women (Protocol). Cochrane Database of Systematic Reviews 2013, Issue 4. Art. No.: CD010496. DOI: 10.1002/14651858.CD010496.

Author Information

  1. 1

    People's Hospital of Deyang City, Department of Obstetrics and Gynecology, Deyang, Sichuan, China

  2. 2

    West China Second University Hospital, West China Women's and Children's Hospital, Department of Obstetrics and Gynecology, Chengdu, Sichuan, China

*Fang Fang, Department of Obstetrics and Gynecology, West China Second University Hospital, West China Women's and Children's Hospital, No. 17, Section Three, Ren Min Nan Lu Avenue, Chengdu, Sichuan, 610041, China. fangf59@yahoo.com.cn.

Publication History

  1. Publication Status: New
  2. Published Online: 30 APR 2013

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Table 1. Species of Candida isolated from lower genital tract in women with VVC

SpeciesFrequencyResponse to Azoles

C. albicans80% – 90%Sensitive

C. glabrata5% – 10%Resistant

C. krusei< 1%Tends to be resistant

C. lusitaniae< 1%Tends to be resistant

C. parapsilosis< 1%Tends to be resistant

C. pseudotropicalis< 1%Tends to be resistant

C. tropicalis< 1%Tends to be resistant

 Notes: Information from references Bieber 2006

 C.: Candida
 
Table 2. CDC-recommended treatments for Uncomplicated VVC

Over-the-Counter Intravaginal Agents:Prescription Intravaginal Agents:

Butoconazole 2% cream 5 g intravaginally for 3 days

OR

Clotrimazole 1% cream 5 g intravaginally for 7–14 days

OR

Clotrimazole 2% cream 5 g intravaginally for 3 days

OR

Miconazole 2% cream 5 g intravaginally for 7 days

OR

Miconazole 4% cream 5 g intravaginally for 3 days

OR

Miconazole 100 mg vaginal suppository, one suppository for 7 days

OR

Miconazole 200 mg vaginal suppository, one suppository for 3 days

OR

Miconazole 1,200 mg vaginal suppository, one suppository for 1 day

OR

Tioconazole 6.5% ointment 5 g intravaginally in a single application
Butoconazole 2% cream (single dose bio-adhesive product), 5 g intravaginally for 1 day

OR

Nystatin 100,000-unit vaginal tablet, one tablet for 14 days

OR

Terconazole 0.4% cream 5 g intravaginally for 7 days

OR

Terconazole 0.8% cream 5 g intravaginally for 3 days

OR

Terconazole 80 mg vaginal suppository, one suppository for 3 days

Notes:

  • CDC = Centers for Disease Control and Prevention



 
Table 3. CDC-recommended treatments for Complicated VVC

RVVC

Initial regimen:

7 – 14 days of any topical azole drug

OR

Fluconazole 100, 150, or 200 mg orally once daily every third day for a total of 3 doses (day 1, 4, and 7)
Maintenance regimen:

Fluconazole 100, 150, or 200 mg orally once weekly for 6 months

Severe VVC

Intravaginally once daily for 7 to 14 days of any topical azole drug

OR

Fluconazole 150 mg orally once daily in two doses (second dose 72 hours after initial dose)

Nonalbicans VVC

Nonfluconazole azole (oral or topical)

Seven to 14 days

OR

Boric acid gelatin capsule

Intravaginally once daily for 14 days

Abnormal host

More prolonged (i.e., 7–14 days) conventional antifungal drugs is necessary

Notes:

  • CDC = Centers for Disease Control and Prevention



 
Table 4. Common micro-organisms used as probiotics

Lactobacillus species:

L. acidophilus

L. bulgaricus

L. casei

L. crispatus

L. fermentum

L. gasseri

L. johnsonii

L. lactis

L. plantarum

L. reuteri

L. rhamnosus GG
Streptococcus species:

S. thermophilus

 

 

 

Yeast:

Saccharomyces boulardii

 

 

 

Other species:

Bacillus cereus

Enterococcus faecalisa

Enterococcus faeciuma

Escherichia coli Nissle

 

 

Bifidobacterium species:

B. adolescentis

B. animalis

B. bifidum

B. breve

B. infantis

B. lactis

B. longum

Notes:

Information from references Senok 2005; Doron 2006; Santosa 2006