Adolescent health

March 2011


Recurrent vulvovaginal candidiasis

Current management

Volume 40, No.3, March 2011 Pages 149-151

Cathy Watson

Marie Pirotta


Management of recurrent vulvovaginal candidiasis can be problematic, and current guidelines are limited by scant evidence.


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 guide them.

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.

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