علاج داء المبيضات الفرجي المهبلي مع النوبات المزمنة المتكررة (أكثر من 4 نوبات سنوياً)

References

DOI: 10.1111/myc.13248

• Many of them have > 4 episodes per year, which is defined as recurrent VVC (RVVC).
• Women with chronic recurrent Candida albicans vulvovaginitis should undergo dose-­reducing maintenance therapy with oral triazoles.
• In cases of chronic RVVC, dose-­reducing suppression therapy with 200 mg oral fluconazole might be considered as follows: three times weekly for one week; followed by once weekly for two months; if symptom-­or fungus-­free, then twice monthly for four months; and finally once monthly for six months (Figure 1).
• Donders et al recommend an initial dose of 200 mg fluconazole for 3 days in the first week in cases with chronic RVVC, followed by a maintenance regimen once the patient is free of symptoms or fungi with 200 mg fluconazole once per month for a duration of one year (Figure 1).
• If 150 mg of fluconazole is administered weekly, the cumulative dose is 3,600 mg at 6 months and 7,200 mg per year, and treatment results are most likely comparable.
• Symptoms? Microscopy/culture negative after 14 days?