PT  - JOURNAL ARTICLE
AU  - Jinping Xu
AU  - Kendra Schwartz
AU  - Monina Bartoces
AU  - Joseph Monsur
AU  - Richard K. Severson
AU  - Jack D. Sobel
TI  - Effect of Antibiotics on Vulvovaginal Candidiasis: A MetroNet Study
AID  - 10.3122/jabfm.2008.04.070169
DP  - 2008 Jul 01
TA  - The Journal of the American Board of Family Medicine
PG  - 261--268
VI  - 21
IP  - 4
4099  - http://www.jabfm.org/content/21/4/261.short
4100  - http://www.jabfm.org/content/21/4/261.full
SO  - J Am Board Fam Med2008 Jul 01; 21
AB  - Purpose: Vulvovaginal candidiasis (VVC) is believed common after systemic antibiotic therapy, yet few studies demonstrate this association. In this pilot study, we evaluate the effect of short-course oral antibiotic use on VVC.Methods: Nonpregnant women aged 18 to 64 years who required ≥3 days oral antibiotics for nongynecological diseases were recruited from a family medicine office. Age-matched (±5 years) women seen in the same clinic for noninfectious problems were recruited as controls. The main outcomes are incidence of symptomatic VVC and prevalence of positive vaginal Candida culture 4 to 6 weeks after antibiotics.Results: Eighty (44 in antibiotic group) women were recruited; 14 of 79 (95% CI, 0.11–0.28) had asymptomatic vaginal Candida cultures positive at baseline. During follow-up, 10 of 27 (95% CI, 0.22–0.56) women in antibiotic group were Candida culture positive. In contrast, 3 of 27 (95% CI, 0.04–0.28) women in the control group were Candida culture positive (relative risk, 3.33; P = .03). Meanwhile, 6 of 27 (95% CI, 0.11–0.41) women in antibiotic group developed symptomatic VVC whereas none (95% CI, 0–0.12) of the women in the control group developed vaginal symptoms (relative risk, ∞; P = .02). Baseline Candida culture did not predict subsequent symptomatic VVC after antibiotics.Conclusion: In this pilot study, the use of short courses of oral antibiotics seems to increase prevalence of asymptomatic vaginal Candida colonization and incidence of symptomatic VVC. Larger cohort studies are needed to confirm these findings.