Objective: To investigate the recurrence rate of vulvovaginal candidiasis from non-albicans species after fluconazole therapy.
Study design: A retrospective cohort of 127 patients with symptomatic vulvovaginal candidiasis by nonalbicans species referred from primary care physicians were evaluated between 1995 and 2004. Complete history, physical examination, basic metabolic panel, and bacterial and fungal cultures were performed. All patients received a daily dose of fluconazole for 30 days. Follow-up evaluations were done at 1, 3, 6, and 12 months.
Results: The recurrence rate for all non-albicans vulvovaginitis was 40.2%, 46.5%, 50.4% and 54.2% at 1, 3, 6, and 12 months, respectively. Patients with symptomatic recurrences were more likely to be younger than 35 years of age, older than 65, nulliparous and fastidious vulvar cleaners and were more likely to have concomitant bacterial infections.
Conclusion: The recurrence rate of symptomatic vulvovaginal candidiasis colonized by non-albicans species after fluconazole therapy was 50.4% at 6 months and 54.2% at 12 months. Nulliparity and age <35 or > 65 years and fastidious vulvar cleaning were positively associated with symptomatic recurrent episodes.