A strategy to reduce the recurrence rate of vaginal candidiasis in women with weakened immunity

Objective. To investigate the clinical efficacy of triazole antifungal agents in the treatment of recurrent vulvovaginal candidiasis. Material and methods. The study comprised 40 patients aged from 33 to 50 years, who were treated at the gynecology department for various diseases of the reproductive system and underwent clinical and laboratory examination. The study group included 30 patients with exacerbation of chronic recurrent vulvovaginal candidiasis (HRVVC). Ten patients without clinical and laboratory evidence of candidal infection were enrolled in the control group. Diagnostic evaluation included a standard clinical examination, bacterioscopic, bacteriological and immunological investigations of the genital tract discharge, determination of the levels of pro- and antiinflammatory cytokines in cervical secretions and phagocytic activity of neutrophils as one of the indicators of local immunity. Patients in the study group received systemic antimycotic therapy concurrently with an immunobiological agent modulating the immune system. Results. All patients in the study group reported a significant improvement in the subjective symptoms. At baseline, the leukocyte phagocytic activity of the cervical secretion in the patient with HRVVC was lower than that among the patients in the control group. After the treatment, the patients in the study group were found to have a 61.2% increase in the phagocytic activity (p < 0.05) and a significant decrease in the concentration of pro-inflammatory cytokines compared with baseline levels. Conclusion. Systemic antimycotic therapy administered concurrently with immunomodulatory agents not only produces an etiotropic effect aimed at the eradication of the pathogen but also helps maintain the post-treatment activity of immunocompetent cells.

vulvovaginal candidiasis, antimycotics, immunity