Maintenance Therapy for Vulvovaginal Candidiasis
Vaginal yeast infection with symptoms such as itching, burning, soreness, vaginal discharge and swelling can significantly affect quality-of-life. Many women use over-the-counter products for self-diagnosed infections, although in a study only about 34% turned out to actually have a yeast infection. It is therefore important to see a physician if the treatment does not result in relief of the symptoms or if symptoms keep recurring.
About 5 to 8% of healthy women in their reproductive years suffer from recurrent bouts of vaginal yeast infections. Although wearing pantyliners or pantyhose and consuming cranberry juice or acidophilus-containing products seems to significantly increase the risk, for most women it is not clear what causes infections to recur.
A new study in the New England Journal of Medicine in August 2004 reports on the efficacy of using weekly doses of Diflucan, which is a safe oral antifungal agent, for suppression of such recurrences. To effect a cure, initial treatment consisted of three doses of Diflucan given at three-day intervals. This was followed by weekly doses of Diflucan 150 mg for 6 months to prevent recurrence.
Six months after the completion of therapy, 90.8 percent of the women in the fluconazole group remained free of candidiasis. However within twelve months after suppression ceased, recurrent infection had developed in 57 percent of the women. The authors concluded that although maintainence therapy with fluconazole appears to be effective and safe, a long-term cure of vulvovaginal candidiasis is difficult to achieve.
