title: Risk factors for recurrent vulvovaginal candidiasis in women receiving maintenance antifungal therapy: results of a prospective cohort study.
abstract: OBJECTIVE
  The purpose of this study was to examine risk factors for symptomatic vulvovaginal candidiasis episodes among women with recurrent vulvovaginal candidiasis (defined as >/=4 vulvovaginal candidiasis episodes in 1 year) who were receiving maintenance antifungal therapy.
  
  
  METHODS
  A prospective study of 65 women aged >/=18 years with recurrent vulvovaginal candidiasis who attended vaginitis clinics in Detroit, Mich, and Philadelphia, Pa.
  
  
  RESULTS
  The 9-month risk of vulvovaginal candidiasis recurrence was 41.8%. Almost two fifths of the women reported activity limitations because of vulvovaginal candidiasis episodes, most or all of the time. Younger women and those women with a history of bacterial vaginosis were at increased risk of vulvovaginal candidiasis episodes. Behavioral factors that were associated significantly with increasing vulvovaginal candidiasis recurrence >/=2- fold included wearing pantyliners or pantyhose and consuming cranberry juice or acidophilus-containing products.
  
  
  CONCLUSIONS
  The use of pantyliners or pantyhose, consumption of cranberry juice or acidophil-containing products, a history of bacterial vaginosis, and age <40 years were positively associated with a symptomatic vulvovaginal candidiasis episode.
authors.affiliation: Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Mich, USA.
authors.forename: Divya A
authors.initials: DA
authors.lastname: Patel
authors.forename: Brenda
authors.initials: B
authors.lastname: Gillespie
authors.forename: Jack D
authors.initials: JD
authors.lastname: Sobel
authors.forename: Debbie
authors.initials: D
authors.lastname: Leaman
authors.forename: Paul
authors.initials: P
authors.lastname: Nyirjesy
authors.forename: M Velma
authors.initials: MV
authors.lastname: Weitz
authors.forename: Betsy
authors.initials: B
authors.lastname: Foxman
mesh_terms: D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use*; D002181:Candidiasis, Vulvovaginal / Q000453:epidemiology / Q000517:prevention & control*; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D055502:Secondary Prevention
chemical_list: D000935:Antifungal Agents