Risk factors for recurrent vulvovaginal candidiasis in women receiving maintenance antifungal therapy: Results of a prospective cohort study

Objective: The purpose of this study was to examine risk factors for symptomatic vulvovaginal candidiasis episodes among women with recurrent vulvovaginal candidiasis (defined as greater than or equal to4 vulvovaginal candidiasis episodes in 1 year) who were receiving maintenance antifungal therapy. Study design: A prospective study of 65 women aged greater than or equal to 18 years with recurrent vulvovaginal candidiasis who attended vaginitis clinics in Detroit, Mich, and Philadelphia, Pa. Results: The 9-month risk of vulvovaginal candidiasis recurrence was 41.8%. Almost two fifths of the women reported activity limitations because of vulvovaginal candidiasis episodes, most or all of the time. Younger women and those women with a history of bacterial vaginosis were at increased risk of vulvovaginal candidiasis episodes. Behavioral factors that were associated significantly with increasing vulvovaginal candidiasis recurrence greater than or equal to 2- fold included wearing pantyliners or pantyhose and consuming cranberry juice or acidophilus-containing products. Conclusion: The use of pantyliners or pantyhose, consumption of cranberry juice or acidophil containing products, a history of bacterial vaginosis, and age <40 years were positively associated with a symptomatic vulvovaginal candidiasis episode. (C) 2004 Elsevier Inc. All rights reserved.