Comparing the Effect of Probiotic and Fluconazole on Treatment and Recurrence of Vulvovaginal Candidiasis: a Triple-Blinded Randomized Controlled Trial
Open accessAbstract
Vaginitis is a common problem in women. Candida albicans is responsible for more than 85% of vaginal fungal infections. The aim of this study was to compare the effects of probiotic and fluconazole on the treatment and recurrence of vulvovaginal candidiasis (VVC). This triple-blinded randomized controlled trial was conducted on 80 married women, aged 18-49 years, with VVC, as confirmed by clinical and laboratory diagnosis. The participants were allocated into two groups using blocked randomization method. The fluconazole-treated group received a single dose of fluconazole (150 mg) supplemented with 30 placebo capsules of probiotic, and the probiotic-treated group got 30 probiotic capsules containing 1 × 10 9 CFU/g LA-5 with 1 fluconazole placebo capsule. The samples were taken from patients to evaluate the vaginal pH and microbiological tests before, 30-35 days, and 60-65 days after starting the treatment. The signs and symptoms were assessed before the intervention and the first and second follow-ups. Chi-square, Fisher's exact, independent t, and ANCOVA tests were then used for data analysis. There was no statistically significant difference between the two groups (p = 0.127) in the frequency of negative culture 30-35 days after starting the treatment, but the frequency of negative culture 60-65 days after starting treatment in the fluconazole group was significantly higher than that of the probiotic group (p = 0.016). The abnormal discharge and vulvovaginal erythema in the first and second follow-ups and also pruritus in the second follow-up in the fluconazole group were significantly lower than those in the probiotic group (p < 0.05). There was, however, no statistically significant difference in burning, frequent urination, dysuria, and dyspareunia between the groups (p > 0.05). Lactobacillus acidophilus supplementation had an effect similar to that of fluconazole in treating most symptoms of VVC, but it was less effective than the latter in preventing recurrence. Trial Registration: Iranian Registry of Clinical Trials (IRCT): IRCT20110826007418N5. Date of registration: 3 March 2021; URL: https://en.irct.ir/trial/50819 ; Date of first registration: 10 March 2021.
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Orally administered azoles can have adverse effects including neutropenia, thrombocytopenia, hepatotoxicity, gastrointestinal disorders, and neurological disorders.
“However, orally administered azoles can have adverse effects, including neutropenia, thrombocytopenia, hepatotoxicity, gastrointestinal disorders, and neurological disorders [67].”
From Statins as Antifungal Agents: A Review on Drug Repurposing and Nanotechnology-Driven Delivery Strategies (2025) · cites this paper as [67]
The Background lists neutropenia, thrombocytopenia, hepatotoxicity, gastrointestinal symptoms, and neurological symptoms as possible side effects of antifungal agents. It says antifungals can be administered orally and identifies azoles as a treatment, but does not specifically attribute every listed effect to orally administered azoles. (LLM, conf=0.82)
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- Authors
- Mollazadeh-Narestan, Z., Yavarikia, P., Homayouni-Rad, A., Samadi Kafil, H., Mohammad-Alizadeh-Charandabi, S., Gholizadeh, P., & Mirghafourvand, M.
- Affiliations
- Tabriz University of Medical Sciences (IR)
- Corresponding author
- Yavarikia, Parisa
- Venue
- Probiotics and Antimicrobial Proteins
- Published
- 2022-10-05
- Volume
- 15
- Issue
- 5
- Pages
- 1436-1446
- ISSN
- 1867-1306 (ISSN-L)
- 1867-1314
- PMC
- PMC9534588
- OpenAlex
- W4302024630
- Cited by
- 29
- References
- 36
- Citations by year
- 2026: 7 · 2025: 14 · 2024: 7 · 2023: 1
- FWCI
- 3.44
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Probiotics and Antimicrobial Proteins (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
- Life Sciences › Agricultural and Biological Sciences › Food Science › Probiotics and Fermented Foods
- Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
- Keywords
- vaginal candidiasis, probiotics, fluconazole, Candida albicans, Lactobacillus acidophilus, vaginal dysbiosis, vaginal pH, vaginal discharge, pruritus, antifungal therapy, women's health, vaginal microbiota restoration, dyspareunia, dysuria
- MeSH terms
- Antifungal Agents, Candidiasis, Vulvovaginal, Capsules, Female, Humans, Iran, Fluconazole, Probiotics
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