Successful treatment of refractory recurrent vaginal candidiasis with cetirizine plus fluconazole.
OBJECTIVE
To determine the prevalence of allergy in patients with recurrent vaginal candidiasis (RVC) and the efficacy of fluconazole in combination with an antihistamine drug in RVC patients who do not respond to fluconazole alone.


METHODS
Participants in the study included 24 women with RVC. All subjects filled out an International Study of Asthma and Allergies in Childhood questionnaire and 23 performed skin prick tests for immediate type 1 hypersensitivity as part of atopy assessment. All subjects were treated with fluconazole 150 mg weekly and were followed every 2 months for 6 months. Those who did not respond to fluconazole alone received cetirizine 10 mg daily in addition to the antifungal medication and were followed up for 6 months.


RESULTS
The majority of women had a history of allergy (60%) and 10 of them (43%) had at least 1 positive result of a skin prick test to aeroallergens. Nineteen patients (79%) responded to fluconazole alone. The 5 patients who remained with symptoms had a medical history of allergy and obtained remission when cetirizine was associated with fluconazole.


CONCLUSIONS
Patients with RVC refractory to standard antifungal therapy and a history of allergy may respond to the combination of antihistamine and antifungal therapy.
Neves
Nilma A
NA
Serviço de Imunologia, Hospital Universitário Prof. Edgard Santos, Universidade Federal da Bahia, Rua João das Botas s/n, Canela 40110-160, Salvador, Bahia, Brazil.
Carvalho
Lucas P
LP
Lopes
Antônio Carlos V
AC
Cruz
Alvaro
A
Carvalho
Edgar M
EM
D000328:Adult; D018926:Anti-Allergic Agents / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use*; D002181:Candidiasis, Vulvovaginal / Q000150:complications / Q000188:drug therapy* / Q000276:immunology; D017332:Cetirizine / Q000627:therapeutic use*; D005260:Female; D015725:Fluconazole / Q000627:therapeutic use*; D039563:Histamine H1 Antagonists, Non-Sedating / Q000627:therapeutic use*; D006801:Humans; D006967:Hypersensitivity / Q000150:complications / Q000188:drug therapy* / Q000276:immunology; D012008:Recurrence; D017211:Treatment Failure; D016896:Treatment Outcome
D018926:Anti-Allergic Agents; D000935:Antifungal Agents; D039563:Histamine H1 Antagonists, Non-Sedating; D015725:Fluconazole; D017332:Cetirizine