Vaginal and oral use of probiotics as adjunctive therapy to fluconazole in patients with vulvovaginal candidiasis: A clinical trial on Iranian women

سال انتشار: 1400
نوع سند: مقاله ژورنالی
زبان: انگلیسی
مشاهده: 69

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شناسه ملی سند علمی:

JR_CUMM-7-3_007

تاریخ نمایه سازی: 11 آذر 1402

چکیده مقاله:

Background and Purpose: Vulvovaginal candidiasis is considered the second mostprevalent gynecologic infection among women and one of the main reasons for referring to a gynecologist. During recent decades, probiotic usage has been defined as one of the therapeutic regimens for vaginal candidiasis management, but these findings were controversial. The current study was conducted to determine the effect of fluconazole plus vaginal and oral probiotics supplementation on clinical and mycological improvement of vaginal candidiasis concomitant with antifungal susceptibility of Candida species to fluconazole.Materials and Methods: This double-blind, randomized, placebo-controlled trial wasconducted on ۷۶ women with vaginal candidiasis admitted to Naghavi and Imam RezaGynecology Clinics in Kashan, Central Iran, from July ۲۰۱۷ to March ۲۰۲۰. Patientswere diagnosed according to vaginal candidiasis symptoms and positive culture forCandida species. The patients were divided into two groups; one of them receivedfluconazole plus vaginal and oral probiotics, while the other one received fluconazolewith placebo. The clinical and mycological findings were recorded before and after thetreatment. In vitro, the fluconazole susceptibility test was determined by themicrodilution method according to the Clinical and Laboratory Standards Institute (M۲۷-A۳) for the baseline Candida isolates.Results: Based on the findings, ۳۵ days after the intervention, a significant reductionwas reported in vaginal candidiasis symptoms in the probiotics supplementation group.Although probiotics supplementation therapy was a better mycological cure, comparedto the fluconazole with the placebo group, this difference was not significant (۶۸.۴% vs.۴۶.۹%, P=۰.۱۸۴). Exclusion of resistant and susceptible dose-dependent strain in theregression model demonstrated a significant reduction in positive culture probiotics inthe supplementation group.Conclusion: Oral and vaginal supplementation with probiotics for ۴ weeks played asignificant role in the elimination of vaginal candidiasis symptoms. Adjustment ofclinical and mycological responses with drug resistance patterns of patients could open a promising horizon for probiotics consumption as a complementary treatment.

نویسندگان

Zahra Vahedpoor

Department of Gynecology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran.

Mahdi Abastabar

Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran

Mojtaba Sehat

Department of Epidemiology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran

Parisa Talebian

Obstetrics and Gynecologist, Kashan, Iran

Tayebeh Felfelian fini

Beheshti Hospital, Kashan University of Medical Sciences, Kashan, Iran

Zahra Dastanpour

Department of Medical Parasitology and Mycology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran

Iman Haghani

Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran

Ramtin Chelongarian

Department of Medical Parasitology and Mycology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran

Mehdi Nazeri

Department of Medical Parasitology and Mycology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran

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