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Vulvovaginal candidiasis

BMJ 2003; 326 doi: (Published 10 May 2003) Cite this as: BMJ 2003;326:993

Over the counter treatment doesn't seem to lead to resistance

  1. Jeanne Marrazzo, medical director (
  1. Harborview Medical Center, Seattle, WA 98104 US

    Like other syndromes affecting the lower genital tract of women, vulvovaginal candidiasis has been regarded as more of a “nuisance infection” than a topic of serious scientific inquiry. New advances in molecular epidemiology, host mucosal immunology, and antifungal treatment have, however, enlivened investigation into this common condition.

    Furthermore, the economic costs of vulvovaginal candidiasis treatment have been well documented, along with the extent to which women treat themselves with a variety of antifungal preparations that are available without a prescription. In 2002 women in the United States spent over half a billion dollars on medications to treat vulvovaginal candidiasis, with about half this amount spent on over the counter preparations.1 This is despite the fact that many women may wrongly diagnose vulvovaginal candidiasis and may be equally or more likely to have bacterial vaginosis, with or without vulvovaginal candidiasis.2

    Truly representative data on the epidemiology of vulvovaginal candidiasis are hard to come by. Vaginal colonisation with Candida, a prerequisite for development of vulvovaginal …

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