title: Effect of norfloxacin therapy for acute, uncomplicated lower urinary tract infection on vaginal Candida prevalence.
abstract: OBJECTIVE
  Acute uncomplicated lower urinary tract infections (UTI) and vulvovaginal candidiasis (VVC) both occur frequently in women. Although VVC is believed to commonly occur after antibiotic therapy, few studies have demonstrated this association. Thus, the aim of the study was to estimate the prevalence of colonization by Candida spp. and VVC after norfloxacin (NOR) use for UTI and the effects on the vaginal microbiota and inflammatory process.
  
  
  METHODS
  This was a prospective cohort study of women with culture-proven UTI who were treated with NOR (antibiotic group). The control group consisted of women with noninfectious diseases or in preventive care. Candida vaginal infections were monitored both clinically and mycologically at baseline and at the follow-up evaluation.
  
  
  RESULTS
  All women showed UTI remission after NOR treatment, and no woman in either group, antibiotic and control, showed symptoms of VVC. Both groups showed similar ratios of a positive Candida culture at baseline (6.7 % and 12.8 %, respectively) and at follow-up (3.3 % and 8.5 %, respectively) (p = 0.2768 and p = 0.5035, respectively). The antibiotic group showed no increased risk of Candida colonization or VVC after NOR treatment compared with the control group [odds ratio (OR) 0.556, 95 % confidence interval (CI) 0.2407-10.05].
  
  
  CONCLUSIONS
  NOR was effective for UTI treatment, did not increase the risk of vaginal colonization by Candida or VVC, and did not lead to major disturbances of the vaginal microbiota.
authors.affiliation: Clinical Cytology Laboratory, Department of Clinical Analysis and Biomedicine, State University of Maringá, Paraná, Brazil.
authors.forename: Rodrigo M
authors.initials: RM
authors.lastname: Rocha
authors.affiliation: Clinical Cytology Laboratory, Department of Clinical Analysis and Biomedicine, State University of Maringá, Paraná, Brazil.|Medical Mycology Laboratory, Department of Clinical Analysis and Biomedicine, State University of Maringá, Paraná, Brazil.
authors.forename: Pâmela C M Delvas
authors.initials: PC
authors.lastname: Zanni
authors.affiliation: Clinical Cytology Laboratory, Department of Clinical Analysis and Biomedicine, State University of Maringá, Paraná, Brazil.|Medical Mycology Laboratory, Department of Clinical Analysis and Biomedicine, State University of Maringá, Paraná, Brazil.
authors.forename: Patrícia
authors.initials: P
authors.lastname: de Souza Bonfim-Mendonça
authors.affiliation: Clinical Cytology Laboratory, Department of Clinical Analysis and Biomedicine, State University of Maringá, Paraná, Brazil.
authors.forename: Fabrícia
authors.initials: F
authors.lastname: Gimenes
authors.affiliation: Clinical Cytology Laboratory, Department of Clinical Analysis and Biomedicine, State University of Maringá, Paraná, Brazil.|Medical Mycology Laboratory, Department of Clinical Analysis and Biomedicine, State University of Maringá, Paraná, Brazil.
authors.forename: Silvia S Dantas
authors.initials: SS
authors.lastname: Alczuk
authors.affiliation: Medical Mycology Laboratory, Department of Clinical Analysis and Biomedicine, State University of Maringá, Paraná, Brazil.
authors.forename: Terezinha I Estivalet
authors.initials: TI
authors.lastname: Svidzinski
authors.affiliation: Clinical Cytology Laboratory, Department of Clinical Analysis and Biomedicine, State University of Maringá, Paraná, Brazil. melconsolaro@gmail.com.|Departamento de Análises Clínicas e Biomedicina, Universidade Estadual de Maringá, Av. Colombro, 5790, Maringá, Paraná, 87020-900, Brazil. melconsolaro@gmail.com.
authors.forename: Márcia E Lopes
authors.identifier: http://orcid.org/0000-0001-9102-4865
authors.initials: ME
authors.lastname: Consolaro
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D001938:Brazil / Q000453:epidemiology; D002175:Candida / Q000302:isolation & purification*; D002181:Candidiasis, Vulvovaginal / Q000453:epidemiology*; D016022:Case-Control Studies; D015169:Colony Count, Microbial; D005260:Female; D006801:Humans; D064307:Microbiota / Q000187:drug effects*; D008875:Middle Aged; D009643:Norfloxacin / Q000494:pharmacology* / Q000627:therapeutic use; D015995:Prevalence; D011446:Prospective Studies; D014552:Urinary Tract Infections / Q000188:drug therapy; D014621:Vagina / Q000382:microbiology*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D009643:Norfloxacin
keywords: Norfloxacin; Treatment; Urinary tract infection; Vaginal Candida colonization; Vaginal microbiota; Vulvovaginal candidiasis