Current features of vulvovaginal candidiasis and selection of rational therapy in pregnant and nonpregnant women

Abstract

Current features of vulvovaginal candidiasis and selection of rational therapy in pregnant and nonpregnant women T.N. Bebneva1,2, G.B. Dikke2 1 Endocrinology Research Centre, Moscow, Russian Federation 2 RUDN UNIVERSITY, Moscow, Russian Federation The article presents the current features of etiology, pathogenesis, clinical course and therapy of vulvovaginal candidiasis (VVC). Currently, in the etiology of VVC the percentage of C. non-albicans has been increasing, the pathogenesis of the disease is affected by the genetic factors, the clinical course of VVC has a high frequency of relapses, it is often accompanied by other infections. In pregnant women VVC occurs twice as often as in non-pregnant women and has a torpid сourse. Association of Candida spp. with dysplastic lesions of the cervix in women with HPV infection has no cause-effect relationship. The preferable variant of VVC therapy are azole preparations with a wide range of action, received vaginally in short courses and increased doses. The recurrent form of VVC is treated in two stages — relieving exacerbation, followed by a course of prolonged suppressive therapy. The article shows the urgency of the use of clotrimazole as one of the recommended first choice drugs. The choice of tactics for managing patients with VVC should be differentiated depending on the etiology, the clinical form of the disease, the concomitant infections. Preferences should be given to a broad spectrum of action, which will improve the effectiveness of treatment and reduce the frequency of recurrence of the disease. Key words: vulvovaginal candidiasis, VVC, biofilms, relapses, antimycotic therapy, pregnancy. For citation: Bebneva T.N., Dikke G.B. Current features of vulvovaginal candidiasis and selection of rational therapy in pregnant and nonpregnant women. Russian journal of Woman and Child Health. 2018;1(1):49–56.