The Effect of use of Vaginal Lactobacillus Rhamnosus for Prevention of Recurrence of Vulvovaginal Candidiasis: A randomized controlled trial

Objectives: The study aims to investigate the role of vaginal administration of Lactobacillus Rhamnosus after vaginal miconazole for prevention of recurrence among women with vulvovaginal candidiasis (VVC). Materials and Methods: A randomized clinical study was done in Women Health Hospital – Assiut University – Egypt. All women presented with symptoms suggestive of VVC to the clinic had been examined and approached for participation. Eligible participants were randomly assigned to one of three groups: Group (A) received lactobacillus containing vaginal capsules daily for one week postmenstrual. Group (B) received vaginal miconazole 400 mg once daily for 3days at bedtime postmenstrual. Group (C) received vaginal miconazole 400 mg once daily for 3 days at bedtime postmenstrual followed by lactobacillus containing vaginal capsules twice daily for one week. The primary outcome was to study the rate of recurrence of symptoms after 1, 3, 6 months of treatment. Results: During the study period, 202 participants with recurrent VVC were approached to participate in this study. No significant differences were found between the three study groups with regards patients’ age, residence, parity. After 1 month, symptoms of VVC recurred in 68.4%, 24.6% and 17.2% of women in group A, B, C consecutively. The recurrence rate increases after 3 months to become 87.5%, 60% and 33.3% consecutively in the three groups. Finally after 6 months, 94.4%, 88.7%, and 44.6% of women in group A, B, C consecutively suffered from RVVC. The recurrence rate is lower in group C (combination group) with statistically significant difference (p=0.0001). Conclusions: Vaginal administration of Lactobacillus Rhamnosus twice daily for 1 week after vaginal miconazole leads to vaginal colonization and associated at 6 months follow up with decrease the recurrence rate of VVC.