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Evidence summaries

Probiotics for Vulvovaginal Candidiasis in Non-Pregnant Women

Compared with conventional antifungal drugs used alone, probiotics as adjuvant therapy might possibly be effective for enhancing short-term clinical and mycological cure, and relapse at one month in vulvovaginal candidiasis. Level of evidence: "D"

Comment: The quality of evidence is downgraded by study limitations (lack of allocation concealment, blinding, and incomplete outcome data in half of the studies) and by imprecise results (wide confidence intervals).

Summary

A Cochrane review [Abstract] 1 included 10 studies with a total of 1656 subjects. Probiotics increased the rate of short-term clinical cure and mycological cure and decreased relapse rate at one month T1. However, this effect did not translate into a higher frequency of long-term clinical cure or mycological cure. Probiotics use did not increase the frequency of serious adverse events (RR 0.80, 95% CI 0.22 to 2.94; 2 trials, n=440).

Probiotics used as adjuvants to antifungal drugs compared with antifungal drugs alone for vulvovaginal candidiasis

OutcomeRelative risk (95% CI)Risk - with control - Antifungal drugRisk with intervention - Antifungal drug and probiotics (95% CI)No of participants (studies)
Clinical cure rate:follow-up 5-10 days1.14 (1.05 to 1.24)721 per 1000822 per 1000 (757 to 894)695 (5)
Clinical cure rate: 1 month after treatmentRR 1.07 (0.86 to 1.33)635 per 1000679 per 1000 (546 to 845)172 (1)
Mycological cure rate: follow-up 5-10 daysRR 1.06 (1.02 to 1.10)880 per 1000933 per 1000 (898 to 968)969 (7)
Mycological cure rate:follow-up 28-30 daysRR 1.26 (0.93 to 1.71)706 per 1000890 per 1000 (657 to 1000)627 (3)
Mycological cure rate: 3 monthsRR 1.16 (1.00 to 1.35)741 per 1000860 per 1000 (741 to 1000)172 (1)
Relapse ratefollow-up: 30-37 days after treatmentRR 0.34 (0.17 to 0.68)145 per 100049 per 1000 (25 to 99)388 (3)

Clinical comments

Note

Date of latest search: 2018-02-05

    References

    • Xie HY, Feng D, Wei DM et al. Probiotics for vulvovaginal candidiasis in non-pregnant women. Cochrane Database Syst Rev 2017;(11):CD010496. [PubMed]

Primary/Secondary Keywords