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Vulvovaginal Candidiasis: A Review of the Evidence for the 2021 Centers for Disease Control and Prevention of Sexually Transmitted Infections Treatment Guidelines
Journal article   Open access   Peer reviewed

Vulvovaginal Candidiasis: A Review of the Evidence for the 2021 Centers for Disease Control and Prevention of Sexually Transmitted Infections Treatment Guidelines

Paul Nyirjesy, Carolyn Brookhart, Gweneth Lazenby, Jane Schwebke and Jack D Sobel
Clinical infectious diseases, v 74(Suppl_2), pp S162-S168
13 Apr 2022
DOI: https://doi.org/10.1093/cid/ciab1057
PMID: 35416967
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://jdc.jefferson.edu/cgi/viewcontent.cgi?article=1087&context=obgynfpView
SubmittedOpen Access (License Unspecified),  Open

Abstract

Antifungal Agents - therapeutic use Candida albicans Candidiasis, Vulvovaginal - diagnosis Candidiasis, Vulvovaginal - drug therapy Candidiasis, Vulvovaginal - prevention & control Centers for Disease Control and Prevention, U.S Female Fluconazole - therapeutic use HIV Infections - complications HIV Infections - drug therapy Humans Pregnancy Saccharomyces cerevisiae United States
Vulvovaginal candidiasis (VVC) is a common cause of vulvovaginal itching and discharge. This article discusses the latest CDC STI Treatment Guidelines for VVC. A literature search of relevant topics was performed, and a team of experts was convened to discuss (1) diagnosis/testing modalities; treatment of (2) uncomplicated VVC , (3) complicated VVC, and (4) VVC caused by non-albicans yeast; (5) alternative treatment regimens; (6) susceptibility testing of yeast; Special Populations: (7) pregnancy and (8) HIV and VVC. Yeast culture remains the gold standard for diagnoses. Newer molecular assays have been developed for the diagnosis of VVC and perform well. Azole antifungals remain the treatment of choice for uncomplicated VVC. Two new drugs, TOL-463 and recently FDA-approved ibrexafungerp, appeared promising in clinical trials. For recurrent VVC, oteseconazole, not yet commercially available, may represent a new option. For non-albicans yeast infections in symptomatic patients, boric acid appears useful. No evidence supports the use of alternative treatments, including probiotics. Fluconazole during pregnancy may be associated with spontaneous abortion and craniofacial and heart defects. In women with HIV infection, lower CD4+ T-cell counts are associated with increased rates of VVC, and VVC is associated with increased viral shedding. Treatment measures in women with HIV infection are identical to those women without HIV infection. There has been significant new knowledge generated about VVC since the 2015 CDC Guidelines which have led to changing recommendations.

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88 citations in Web of Science
73 citations in Scopus

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
Web of Science research areas
Immunology
Infectious Diseases
Microbiology
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