Poor quality of life in patients with chronic vulvovaginal candidiasis: A before-after study on the impact of oral fluconazole therapy

Background/Objective: Chronic vulvovaginal candidiasis (CVVC) is a disorder characterised by signs and symptoms of vulvovaginal inflammation, causally associated with the presence of Candida species in the vagina.(Fischer 2012, Hong, Dixit et al. 2013) This study aims to establish the impact on quality of life (QoL) and to report the effect on QoL of treatment with fluconazole in CVVC.
Methods: Before-After study conducted in vulvar dermatology clinics in Sydney, Australia. Patients were assessed at baseline by the dermatology quality of life index (DLQI) and visual analogue scale (VAS) grading of erythema at baseline and at 12 weeks after an oral fluconazole regime. Primary outcome measures were change in DLQI score and VAS grading. Secondary outcome measures were tolerability and adverse events.
Results: A total of 82 of 91 patients (90.1%) completed the study. The mean drop in DLQI score was 11.6 (95% CI [10.1, 13.0]) (p<0.001). The post-treatment VAS scores were significantly lower than the pre-treatment scores (p<0.001). Adverse effects requiring cessation of fluconazole occurred in 3.7% of patients.
Conclusions: Fluconazole treatment at a dose of 50-100mg daily achieved significant observable and QoL improvement in 96.3% of patients with CVVC within 12 weeks of treatment. Adverse effects were minimal.
1. Fischer, G. (2012). "Chronic vulvovaginal candidiasis: What we know and what we have yet to learn." Australasian Journal of Dermatology 53(4): 247-254.
2. Hong, E., S. Dixit, P. L. Fidel, J. Bradford and G. Fischer (2013). "Vulvovaginal Candidiasis as a Chronic Disease: Diagnostic Criteria and Definition." J Low Genit Tract Dis.

Dr. Yvonne Nguyen

1) Dermatology Department, Royal Prince Alfred Hospital 2) Discipline of Dermatology, Sydney Medical

Yvonne Nguyen is currently a dermatology research registrar at the Royal Prince Alfred Hospital after having previously completed her internship and residency at the Royal North Shore Hospital. She received Bachelor of Pharmacy (Hons), MBBS and MPhil (Medicine) degrees from The University of Sydney. Her main research experience is in the area of Chronic Vulvovaginal Candidiasis, which she undertook in fulfilment of her Master of Philosophy (Medicine) degree from The University of Sydney.