Management of recurrent vulvovaginal candidosis: Narrative review of the literature and European expert panel opinion.
| Autor: | Donders G; Femicare VZW, Clinical Research for Women, Tienen, Belgium.; Department of Obstetrics and Gynecology, University Hospital Antwerp, Antwerp, Belgium.; Department of Obstetrics and Gynecology, Regional Hospital Tienen, Tienen, Belgium., Sziller IO; Dél-budai Centrumkórház, Szent Imre Egyetemi Oktatókórház, Szülészet és Nőgyógyászati Osztály, Budapest, Hungary., Paavonen J; Department of Obstetrics and Gynecology, Helsinki University Hospital, Helsinki, Finland., Hay P; Guys and St. Thomas' NHS Foundation Trust, London, United Kingdom., de Seta F; Department of Medical, Surgical and Health Sciences, Institute for Maternal and Child Health, University of Trieste, IRCCS Burlo Garofolo, Trieste, Italy., Bohbot JM; Department of Sexually Transmitted Infections, Institut Alfred Fournier, Paris, France., Kotarski J; Department of Oncological Gynecology and Gynecology, Medical University of Lublin, Lublin, Poland., Vives JA; Department of Gynecology and Obstetrics, Hospital CIMA, Barcelona, Spain., Szabo B; Department of Obstetrics-Gynecology, 'George Emil Palade' University of Medicine, Pharmacy, Science and Technology, Targu-Mures, Romania., Cepuliené R; Gedeon Richter Plc., Budapest, Hungary., Mendling W; Deutsches Zentrum für Infektionen in Gynäkologie und Geburtshilfe, Helios Universitätsklinikum Wuppertal, Wuppertal, Germany. |
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| Jazyk: | angličtina |
| Zdroj: | Frontiers in cellular and infection microbiology [Front Cell Infect Microbiol] 2022 Sep 09; Vol. 12, pp. 934353. Date of Electronic Publication: 2022 Sep 09 (Print Publication: 2022). |
| DOI: | 10.3389/fcimb.2022.934353 |
| Abstrakt: | Recurrent vulvovaginal candidosis (RVVC) is a chronic, difficult to treat vaginal infection, caused by Candida species, which affects women of all ages and ethnic and social background. A long-term prophylactic maintenance regimen with antifungals is often necessary. In most clinical practice guidelines, oral fluconazole is recommended as the first-line treatment. Although clinical resistance to antifungal agents remains rare, overexposure to azoles may increase the development of fluconazole-resistant C . albicans strains. In addition, non-albicans Candida species are frequently dose-dependent susceptible or resistant to fluconazole and other azoles, and their prevalence is rising. Available therapeutic options to treat such fluconazole-resistant C. albicans and low susceptibility non- albicans strains are limited. Ten experts from different European countries discussed problematic issues of current RVVC diagnosis and treatment in two audiotaped online sessions and two electronic follow-up rounds. A total of 340 statements were transcribed, summarized, and compared with published evidence. The profile of patients with RVVC, their care pathways, current therapeutic needs, and potential value of novel drugs were addressed. Correct diagnosis, right treatment choice, and patient education to obtain adherence to therapy regimens are crucial for successful RVVC treatment. As therapeutic options are limited, innovative strategies are required. Well- tolerated and effective new drugs with an optimized mechanism of action are desirable and are discussed. Research into the impact of RVVC and treatments on health-related quality of life and sex life is also needed. Competing Interests: GD, IS, JP, PH, FS, JB, JK, JV, BS, and WM are expert consultants to the pharmaceutical industry, including Gedeon Richter. RC is an employee at Gedeon Richter.This study received funding from Gedeon Richter Plc. The funder had the following involvement with the study: design and collection of data, and on the decision to submit the manuscript for publication. Authors led the analysis and interpretation of data, and the writing of the manuscript. All authors declare no other competing interests. (Copyright © 2022 Donders, Sziller, Paavonen, Hay, de Seta, Bohbot, Kotarski, Vives, Szabo, Cepuliené and Mendling.) |
| Databáze: | MEDLINE |
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