Comparing the effect of probiotic and fluconazole in treatment and recurrent of vaginal candidiasis: A three-blind randomized controlled trial

Abstract

Abstract Vaginitis is a common problem in women. Candida albicans is responsible for more than 85% of vaginal fungal infections. The aim of this study was to compare the efects of probiotic and fuconazole on the treatment and recurrence of vulvovaginal candidiasis (VVC). This triple-blinded randomized controlled trial was conducted on 80 married women, aged 15–49 years, with VVC, as confrmed by clinical and laboratory diagnosis. The participants were allocated into two groups using blocked randomization method. The fuconazole-treated group received a single dose of fuconazole (150 mg) supplemented with 30 placebo capsules of probiotic, and the probiotic-treated group got 30 probiotic capsules containing 1× 109 CFU/g LA-5 with 1 fuconazole placebo capsule. The samples were taken from patients to evaluate the vaginal pH and microbiological tests before, 35–40 days, and 60–65 days after starting the treatment. The signs and symptoms were assessed before the intervention and the frst and second follow-ups. Chi-square, Fisher’s exact, independent t, and ANCOVA tests were then used for data analysis. There was no statistically signifcant diference between the two groups (p=0.127) in the frequency of negative culture 35–40 days after starting the treatment, but the frequency of negative culture 60–65 days after starting treatment in the fuconazole group was signifcantly higher than that of the probiotic group (p=0.016). The abnormal discharge and vulvovaginal erythema in the frst and second follow-ups and also pruritus in the second follow-up in the fuconazole group were signifcantly lower than those in the probiotic group (p<0.05). There was, however, no statistically signifcant diference in burning, frequent urination, dysuria, and dyspareunia between the groups (p>0.05) Lactobacillus acidophilus supplementation had an efect similar to that of fuconazole in treating most symptoms of VVC, but it was less efective than the latter in preventing recurrence. Trial Registration: Iranian Registry of Clinical Trials (IRCT): IRCT20110826007418N5. Date of registration: 2021-03-03