title: Effect of antibiotics on vulvovaginal candidiasis: a MetroNet study.
abstract: OBJECTIVE
  Vulvovaginal candidiasis (VVC) is believed common after systemic antibiotic therapy, yet few studies demonstrate this association. In this pilot study, we evaluate the effect of short-course oral antibiotic use on VVC.
  
  
  METHODS
  Nonpregnant women aged 18 to 64 years who required >or=3 days oral antibiotics for nongynecological diseases were recruited from a family medicine office. Age-matched (+/-5 years) women seen in the same clinic for noninfectious problems were recruited as controls. The main outcomes are incidence of symptomatic VVC and prevalence of positive vaginal Candida culture 4 to 6 weeks after antibiotics.
  
  
  RESULTS
  Eighty (44 in antibiotic group) women were recruited; 14 of 79 (95% CI, 0.11-0.28) had asymptomatic vaginal Candida cultures positive at baseline. During follow-up, 10 of 27 (95% CI, 0.22-0.56) women in antibiotic group were Candida culture positive. In contrast, 3 of 27 (95% CI, 0.04-0.28) women in the control group were Candida culture positive (relative risk, 3.33; P = .03). Meanwhile, 6 of 27 (95% CI, 0.11-0.41) women in antibiotic group developed symptomatic VVC whereas none (95% CI, 0-0.12) of the women in the control group developed vaginal symptoms (relative risk, infinity; P = .02). Baseline Candida culture did not predict subsequent symptomatic VVC after antibiotics.
  
  
  CONCLUSIONS
  In this pilot study, the use of short courses of oral antibiotics seems to increase prevalence of asymptomatic vaginal Candida colonization and incidence of symptomatic VVC. Larger cohort studies are needed to confirm these findings.
authors.affiliation: Department of Family Medicine and Public Health Sciences, Division of Practice-Based Research, Wayne State University School of Medicine, Detroit, Michigan, USA.
authors.forename: Jinping
authors.initials: J
authors.lastname: Xu
authors.forename: Kendra
authors.initials: K
authors.lastname: Schwartz
authors.forename: Monina
authors.initials: M
authors.lastname: Bartoces
authors.forename: Joseph
authors.initials: J
authors.lastname: Monsur
authors.forename: Richard K
authors.initials: RK
authors.lastname: Severson
authors.forename: Jack D
authors.initials: JD
authors.lastname: Sobel
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002175:Candida / Q000302:isolation & purification; D002181:Candidiasis, Vulvovaginal / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D015169:Colony Count, Microbial; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D015995:Prevalence; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents