The DOI matches its Crossref record; 24 of the 24 references it cites were found in a registry or an index.
Prognosis and Long-Term Outcome of Women With Idiopathic Recurrent Vulvovaginal Candidiasis Caused by Candida albicans
Abstract
Objectives: This study evaluated use of long-term fluconazole beyond an initial 6-month course of weekly fluconazole in premenopausal patients with idiopathic recurrent vulvovaginal candidiasis (RVVC) due to Candida albicans. Materials and Methods: A retrospective chart review was performed of women seen in Wayne State University Vaginitis Clinic with culture-confirmed idiopathic RVVC due to Candida albicans during a 10-year period (January 2006 to December 2015). Only patients without risk factors for secondary VVC and who initiated a 6-month course of weekly fluconazole therapy were selected. Data included long-term use of fluconazole therapy, treatment efficacy, and development of fluconazole resistance. Questionnaires were mailed to evaluate patient's experience after fluconazole therapy. Results: Of 883 patients with RVVC based on clinical records, 191 with culture positive idiopathic RVVC due to C. albicans were started on the maintenance fluconazole regimen, and 147 (77.0%) completed 6 months of therapy. Of these, 107 (72.8%) continued or received maintenance past 6 months. The most common reason for additional fluconazole therapy was culture-confirmed VVC recurrence (55.1%), unconfirmed but possible VVC recurrence (16.8%), and patient preference (10.3%). The mean duration of fluconazole maintenance was 35.7 (range = 7–288) months. Fluconazole resistance emerged in 7.5% completing 6-month therapy. Upon questionnaire follow-up, 93.6% of 51 respondents reported benefit during maintenance regimen; however, 80.9% described relapse after discontinuing weekly therapy. Conclusions: Fluconazole suppression therapy was highly effective in preventing VVC symptoms but was rarely curative and VVC relapse occurred frequently after discontinuation of maintenance therapy. The development of drug resistance in C. albicans isolates after long-term fluconazole maintenance therapy although uncommon is a previously unrecognized complication.
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In the citing paper
“women infected with resistant strains may not achieve symptom remission because of the limited number of treatment options effective against azole-resistant Candida species. 13”
From Clinical challenges in diagnosis and treatment of recurrent vulvovaginal candidiasis (2022) · cites this paper as [13]
In the citing paper
“but infection recurs in up to 50% of women treated.”
From Clinical challenges in diagnosis and treatment of recurrent vulvovaginal candidiasis (2022) · cites this paper as [13]
In the citing paper
“Repeated use of fluconazole also increases risk for the development of resistant strains.13,18,26”
From Clinical challenges in diagnosis and treatment of recurrent vulvovaginal candidiasis (2022) · cites this paper as [13]
In the citing paper
“During follow-up, 93.6% of 51 women reported benefits during the maintenance regimen, but 80.9% described relapse after discontinuing the weekly treatment (Collins et al., 2020).”
From Management of recurrent vulvovaginal candidosis: Narrative review of the literature and European expert panel opinion (2022) · cites this paper as Collins et al., 2020
In the citing paper
“Fluconazole-resistant C. albicans vaginitis usually represents less than 5% of isolates obtained from women with RVVC (Sobel and Sobel, 2018; Collins et al., 2020).”
From Management of recurrent vulvovaginal candidosis: Narrative review of the literature and European expert panel opinion (2022) · cites this paper as Collins et al., 2020
Citations
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Centers for Disease Control and Prevention Sexually Transmitted Diseases Treatment Guidelines
Workowski, K., & Berman, S. M. (2007) · Clinical Infectious Diseases · doi:10.1086/511430 · Cited by 1,977
Sobel, J. D. (2007) · The Lancet · doi:10.1016/s0140-6736(07)60917-9 · Cited by 1,270
Self-citationSTAT1 Mutations in Autosomal Dominant Chronic Mucocutaneous Candidiasis
van de Veerdonk, F. L., Plantinga, T. S., Hoischen, A., Smeekens, S. P., Joosten, L. A. B., Gilissen, C., Arts, P., Rosentul, D. C., Carmichael, A., der Graaf, C. A. A. S.-V., et al. (2011) · New England Journal of Medicine · doi:10.1056/nejmoa1100102 · Cited by 684
Global burden of recurrent vulvovaginal candidiasis: a systematic review
Denning, D. W., Kneale, M., Sobel, J. D., & Rautemaa-Richardson, R. (2018) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(18)30103-8 · Cited by 639
Self-citationRecurrent vulvovaginal candidiasis
Sobel, J. D. (2016) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2015.06.067 · Cited by 502
Self-citationMaintenance Fluconazole Therapy for Recurrent Vulvovaginal Candidiasis
Sobel, J. D., Wiesenfeld, H. C., Martens, M., Danna, P., Hooton, T. M., Rompalo, A., Sperling, M., Livengood, C., Horowitz, B., Von Thron, J., et al. (2004) · New England Journal of Medicine · doi:10.1056/nejmoa033114 · Cited by 487
Self-citationImmunopathogenesis of recurrent vulvovaginal candidiasis
Fidel, P. L., & Sobel, J. D. (1996) · Clinical Microbiology Reviews · doi:10.1128/cmr.9.3.335 · Cited by 298
Self-citationFoxman, B., Muraglia, R., Dietz, J.-P., Sobel, J. D., & Wagner, J. (2013) · Journal of Lower Genital Tract Disease · doi:10.1097/lgt.0b013e318273e8cf · Cited by 261
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- 2014, The role of human dectin – 1 Y238X gene polymorphisan in recurrent vulvovaginal candidiasis infections, MolBiol Rep, 41, 6763
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Martens, M. G., Maximos, B., Degenhardt, T., Person, K., Curelop, S., Ghannoum, M., Flynt, A., & Brand, S. R. (2022) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2022.07.023 · Cited by 86
Oteseconazole: An Advance in Treatment of Recurrent Vulvovaginal Candidiasis
Sobel, J. D., & Nyirjesy, P. (2021) · Future Microbiology · doi:10.2217/fmb-2021-0173 · Cited by 78
Self-citationDonders, G., Sziller, I. O., Paavonen, J., Hay, P., de Seta, F., Bohbot, J. M., Kotarski, J., Vives, J. A., Szabo, B., Cepuliené, R., et al. (2022) · Frontiers in Cellular and Infection Microbiology · doi:10.3389/fcimb.2022.934353 · Cited by 82
Clinical challenges in diagnosis and treatment of recurrent vulvovaginal candidiasis
Neal, C. M., & Martens, M. G. (2022) · SAGE Open Medicine · doi:10.1177/20503121221115201 · Cited by 56
Efficacy and Safety of Oteseconazole in Recurrent Vulvovaginal Candidiasis
Sobel, J. D., Donders, G., Degenhardt, T., Person, K., Curelop, S., Ghannoum, M., & Brand, S. R. (2022) · NEJM Evidence · doi:10.1056/evidoa2100055 · Cited by 55
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Metadata
- Authors
- Collins, L. M., Moore, R., & Sobel, J. D.
- Affiliations
- Wayne State University (US)
- ORCID
- Sobel, Jack D.
- Venue
- Journal of Lower Genital Tract Disease
- Published
- 2020-01
- Volume
- 24
- Issue
- 1
- Pages
- 48-52
- ISSN
- 1089-2591 (ISSN-L)
- 1526-0976
- OpenAlex
- W2994988388
- Cited by
- 55
- References
- 24
- Citations by year
- 2026: 4 · 2025: 10 · 2024: 7 · 2023: 17 · 2022: 11 · 2021: 4 · 2020: 2
- FWCI
- 3.26
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Lower Genital Tract Disease (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
- Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
- Health Sciences › Medicine › Urology › Urinary Tract Infections Management
- Keywords
- recurrent vulvovaginal candidiasis, Candida albicans, fluconazole, long-term outcomes, fluconazole resistance, relapse after treatment discontinuation, premenopausal women, treatment efficacy
- MeSH terms
- Adolescent, Adult, Antifungal Agents, Candida albicans, Candidiasis, Vulvovaginal, Female, Humans, Michigan, Middle Aged, Prognosis, Surveys and Questionnaires, Recurrence, Retrospective Studies, Fluconazole, Treatment Outcome, Drug Resistance, Fungal, Young Adult
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