Acute Vaginal Candidiasis: A review of treatment guidelines and Siriraj experience

Abstract

Acute vaginal candidiasis (VC) is a leading cause of abnormal vaginal discharge at gynecologic clinics. The most common causative organism is Candida albicans, which is one of the vaginal normal flora. Therefore, VC is not considered as being a sexually-transmitted disease (STD). Host factors such as a disturbance of vaginal ecosystem, a prolonged use of antibiotics and individual hormonal effect appear to precipitate the condition. Although symptoms and signs of VC are unique, the diagnosis also requires a basic tool like a microscope. Azole antifungals are recommended as the first-line treatment in all guidelines. However, lifestyle modification is apparently as important. As the Siriraj Female STD Clinic (Clinic 309) has been taking of this group of patients and has conducted some clinical trials on this issue, we would like to review current treatment guidelines of acute VC and to share some of our experience.