Journal
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
Volume 214, Issue 1, Pages 15-21Publisher
MOSBY-ELSEVIER
DOI: 10.1016/j.ajog.2015.06.067
Keywords
antifungals; antimycotics; Candida vaginitis; vaginal candidosis; vulvovaginal candidiasis
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Recurrent vulvovaginal candidiasis (RVVC) is a common cause of significant morbidity in women in all strata of society affecting millions of women worldwide. Previously, RVVC occurrence was limited by onset of menopause but the widespread use of hormone replacement therapy has extended the at-risk period. Candida albicans remains the dominant species responsible for RVVC, however optimal management of RVVC requires species determination and effective treatment measures are best if species-specific. Considerable progress has been made in understanding risk factors that determine susceptibility to RVVC, particularly genetic factors, as well as new insights into normal vaginal defense immune mechanisms and their aberrations in RVVC. While effective control of RVVC is achievable with the use of fluconazole maintenance suppressive therapy, cure of RVVC remains elusive especially in this era of fluconazole drug resistance. Vaccine development remains a critical challenge and need.
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