Weekly fluconazole therapy for recurrent vulvovaginal candidiasis: a systematic review and meta-analysis

Objective: To investigate the efficacy, compared to placebo, of fluconazole 150 mg weekly, given for six months as prophylaxis against recurrent vulvovaginal candidiasis (RVVC). Study design: A quantitative systematic review was performed, and randomized controlled trials were included. We conducted searches at Medline, EMBASE, Lilacs, Cochrane Library and ICI Web of Science from 1980 to March 2012. We used the odds ratio (OR) with confidence intervals (CI) of 95% using a random effects model of Mantel-Haenszel. The software used was Review Manager version 5.0. Results: Through the search strategies we identified 249 articles, of which only two were part of the meta-analysis. Fluconazole was more effective than placebo in reducing symptomatic episodes of WC, immediately after treatment (OR 0.10, 95% CI 0.03-0.34), 3 months after treatment (OR 0.23, 95% CI 0.07-0.74) and 6 months after treatment (OR 0.39, 95% CI 0.24-0.64). Conclusion: Weekly treatment with fluconazole (150 mg) for six months is effective against RVVC. (c) 2012 Elsevier Ireland Ltd. All rights reserved.