Vaginitis is one of the most common reasons for women to access healthcare, and results in significant personal cost and morbidity, as well as cost to the health dollar.1 Treatment of uncomplicated vulvovaginal candidiasis, which affects around 75% of women at some stage of their lives,2 is well supported by evidence and results in few long term sequelae. However, recurrent vulvovaginal candidiasis, which has been defined as four or more episodes of vulvovaginal candidiasis in 12 months,2 affects around 5–8% of women of reproductive age,2 and often has a severe impact on the lives of sufferers. Successful management of this condition is problematic, yet recurrent vulvovaginal candidiasis is the subject of relatively few quality randomised controlled trials, and there are currently no supporting systematic reviews. Although widely used to inform management in Australia, the Therapeutic Guidelines3 concede that consensus on management of this condition is not decisive.
Management of recurrent vulvovaginal
candidiasis can be problematic, and
current guidelines are limited by scant
The authors found no research on
how clinicians manage this condition
and whether existing guidelines were
followed. To ascertain how recurrent
vulvovaginal candidiasis is managed in
current clinical practice, a survey was
conducted of delegates at a seminar
for health professionals with a special
interest in vulval conditions.
Of the 160 delegates 66 completed
the survey, providing a response
rate of 41%. The authors found little
adherence to current guidelines – only
50% reported using the recommended
suppression and maintenance
therapy, and only 57% reported using
confirmatory diagnostic testing.
The wide variation in health
professionals’ management of recurrent
vulvovaginal candidiasis reflects the
difficulty in treating and managing
this condition. The results suggest that
clinicians are ‘tailoring’ treatment to
their patients due to a lack of good
evidence of effective treatments to
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