Over‐the‐Counter Antifungal Drug Misuse Associated With Patient‐Diagnosed Vulvovaginal Candidiasis

  title={Over‐the‐Counter Antifungal Drug Misuse Associated With Patient‐Diagnosed Vulvovaginal Candidiasis},
  author={D. Ferris and P. Nyirjesy and J. Sobel and D. Soper and A. Pavletic and M. Litaker},
  journal={Obstetrics \& Gynecology},
OBJECTIVE To estimate what proportion of symptomatic women purchasing over‐the‐counter antifungal products for immediate treatment of presumed vulvovaginal candidiasis have vulvovaginal candidiasis or other genitourinary conditions. METHODS A time‐location sample of 95 symptomatic women who purchased and presented with an over‐the‐counter antifungal product for immediate and personal treatment of presumed vulvovaginal candidiasis were evaluated by clinical examination and pertinent laboratory… Expand
Epidemiology and antifungal susceptibility patterns of Candida isolates from Greek women with vulvovaginal candidiasis
It is demonstrated that VVC is a common infection among women in Crete, Greece, with C. albicans being the predominant species involved, with resistance to antifungals was infrequent and resistance to fluconazole among C.Albicans isolates was found to significantly increase with time. Expand
Vaginitis: Diagnosis and Treatment.
Vaginitis is defined as any condition with symptoms of abnormal vaginal discharge, odor, irritation, itching, or burning. The most common causes of vaginitis are bacterial vaginosis, vulvovaginalExpand
Telephone Triage: Diagnosis of Candidiasis Based Upon Self-Reported Vulvovaginal Symptoms
Objective The study aimed to determine which self-reported vulvovaginal symptoms are most consistent with candidiasis confirmed by yeast culture and to establish guidelines to determine who can beExpand
Guideline: Vulvovaginal Candidosis (AWMF 015/072), S2k (excluding chronic mucocutaneous candidosis)
Although it is not necessary to treat a vaginal colonisation of Candida in healthy women, vaginal administration of antimycotics is often recommended in the third trimester of pregnancy in Germany to reduce the rate of oral thrush and napkin dermatitis in healthy full‐term newborns. Expand
Highly-cited estimates of the cumulative incidence and recurrence of vulvovaginal candidiasis are inadequately documented
The extent to which vulvovaginal candidiasis is a source of population-level morbidity remains uncertain and population-based studies are needed to make reliable estimates of the lifetime risk of vulvosorbent candidiasis and the proportion of women who experience recurrent candidiasis. Expand
Prevalence and treatment outcome of vulvovaginal candidiasis in pregnancy in a rural community in Enugu State, Nigeria
The result showed that the pregnant women had non-complicated VVC, and the pharmacoeconomics of both agents reveal a remarkable difference in that a week treatment of nystatin costs ninety-one naira (N91. 00) which is less than $1 and clotrimazole for the same duration costs one hundred and sixtyeight nairA (N168.5). Expand
Vaginitis: Making Sense of Over-the-Counter Treatment Options
Background. The FDA approved over-the-counter (OTC) use of vaginal antifungals in 1990. Subsequently, a plethora of OTC products have become available to women on drugstore shelves. Objectives. TheExpand
Vaginitis: making sense of over-the-counter treatment options.
BACKGROUND The FDA approved over-the-counter (OTC) use of vaginal antifungals in 1990. Subsequently, a plethora of OTC products have become available to women on drugstore shelves. OBJECTIVES TheExpand
Guideline: Vulvovaginal candidosis (AWMF 015/072, level S2k)
Approximately 70‐75% of women will have vulvovaginal candidosis (VVC) at least once in their lifetime. In premenopausal, pregnant, asymptomatic and healthy women and women with acute VVC, CandidaExpand
Treatment of vaginal Candida infections
  • J. Sobel
  • Medicine
  • Expert opinion on pharmacotherapy
  • 2002
Candida vaginitis is most commonly caused by Candida albicans (> 85%) with little evidence of an increase in vaginitis due to non-C. albicans species. Epidemiological studies are no longer possibleExpand


Women's use of over-the-counter antifungal medications for gynecologic symptoms.
A minority of women were able to correctly diagnose VVC from a classic case scenario, and women likely use OTC antifungals inappropriately to treat gynecologic conditions that are similar but potentially more severe. Expand
Over‐the‐Counter and Alternative Medicines in the Treatment of Chronic Vaginal Symptoms
Women with chronic vaginal symptoms often use over-the-counter and alternative medicines that add to health care costs and are unlikely to be of benefit. Expand
Bacterial vaginosis and trichomoniasis vaginitis are risk factors for cuff cellulitis after abdominal hysterectomy.
Patients with either bacterial vaginosis or trichomoniasis vaginitis were more likely than control subjects to have cuff cellulitis, cuff abscess, or both, and preoperative vagina evaluation had no effect with respect to the incidence of postoperative wound infection, urinary tract infection, or intravenous line phlebitis. Expand
The limited value of symptoms and signs in the diagnosis of vaginal infections.
It is concluded that presenting symptoms and signs invaginitis evaluation have limited value, and that half of the women with vaginitis may lack a microbiologic diagnosis. Expand
Self-medication with vaginal antifungal drugs: physicians' experiences and women's utilization patterns.
Concerns about inappropriate use and women's ability to self-diagnose correctly are raised and two ways to address these concerns are for physicians and pharmacy personnel to provide spontaneous information and to have more informative advertisements on vaginal antifungal drugs. Expand
Differentiation of Gardnerella vaginalis, Candida albicans, and Trichomonas vaginalis infections of the vagina.
This study evaluated the positive predictive values of factors associated with Gardnerella vaginalis, Candida albicans, and Trichomonas vaginalis for diagnosing vaginitis in a community-basedExpand
Office laboratory diagnosis of vaginitis. Clinician-performed tests compared with a rapid nucleic acid hybridization test.
Primary care clinicians demonstrated a high specificity but low sensitivity when identifying vaginal trichomoniasis and vulvovaginal candidiasis by microscopic techniques, but Clinicians were not as accurate as the DNA probe test in diagnosing vaginal infections. Expand
Vulvovaginal candidiasis: epidemiologic, diagnostic, and therapeutic considerations.
Although it is the second most common vaginal infection in North America, vulvovaginal candidiasis is a non-notifiable disease and has been excluded from the ranks of sexually transmitted diseases.Expand
Impact of Vaginal Antifungal Products on Utilization of Health Care Services: Evidence from Physician Visits
It appears that the availability of OTC anticandidal fungal preparations reduces the number of physician visits for vaginitis, resulting in cost savings. Expand
Nonspecific vaginitis. Diagnostic criteria and microbial and epidemiologic associations.
Application of practical diagnostic criteria for standard clinical use should assist in clinical management of nonspecific vaginitis and in further study of the microbiologic and biochemical correlates and the pathogenesis of this mild but quite prevalent disease. Expand