Candidiasis (vulvovaginal).
BACKGROUND
Vulvovaginal candidiasis is estimated to be the second most common cause of vaginitis after bacterial vaginosis. Candida albicans accounts for 85-90% of cases.


METHODS
We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of drug treatments, alternative or complementary treatments for acute vulvovaginal candidiasis in non-pregnant symptomatic women? What are the effects of treating a male sexual partner to resolve symptoms and prevent recurrence in non-pregnant women with symptomatic acute vulvovaginal candidiasis? What are the effects of drug treatments, alternative or complementary treatments for recurrent vulvovaginal candidiasis in non-pregnant symptomatic women? What are the effects of treating a male sexual partner in non-pregnant women with symptomatic recurrent vulvovaginal candidiasis? What are the effects of treating asymptomatic non-pregnant women with a positive swab for candidiasis? We searched: Medline, Embase, The Cochrane Library and other important databases up to October 2006 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).


RESULTS
We found 58 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.


CONCLUSIONS
In this systematic review we present information relating to the effectiveness and safety of the following interventions: alternative or complementary treatments, douching, drug treatments, garlic, intravaginal preparations (boric acid, nystatin, imidazoles, tea tree oil), oral fluconazole, oral itraconazole, treating a male sexual partner, and yoghurt containing Lactobacillus acidophilus (oral or vaginal).
Spence
Des
D
General Practice, Glasgow University, Glasgow, Scotland.
D000282:Administration, Intravaginal; D000284:Administration, Oral; D002181:Candidiasis, Vulvovaginal; D002986:Clinical Trials as Topic; D006801:Humans; D059413:Intraabdominal Infections; D014486:United States Food and Drug Administration; D016585:Vaginosis, Bacterial