Risk factors for recurrent vulvovaginal candidiasis in women receiving maintenance antifungal therapy: results of a prospective cohort study.
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.
Patel
Divya A
DA
Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Mich, USA.
Gillespie
Brenda
B
Sobel
Jack D
JD
Leaman
Debbie
D
Nyirjesy
Paul
P
Weitz
M Velma
MV
Foxman
Betsy
B
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
D000935:Antifungal Agents