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Pure versus Complicated Vulvar Vestibulitis: A Randomized Trial of Fluconazole Treatment

2000; Karger Publishers; Volume: 50; Issue: 3 Linguagem: Inglês

10.1159/000010309

1423-002X

Jacob Bornstein, Galit Livnat, Zmira Stolar, H Abramovici,

Acne and Rosacea Treatments and Effects

<i>Objective:</i> To examine the effectiveness of a 6-month treatment consisting of a weekly oral dose of 150 mg fluconazole for women with vestibulitis, and to explore the causes of treatment failure. <i>Methods:</i> Forty women with vestibulitis were randomized to either of two treatment groups. One group received a 6-month low oxalate diet with calcium citrate complement, as a placebo, and the second group the same diet and calcium citrate with the addition of a weekly oral tablet of 150 mg fluconazole. The women were examined 3 months after completing treatment, for response to therapy. <i>Results:</i> The addition of intensive 6-month fluconazole treatment did not lead to an outcome better than that attained by maintaining a low oxalate diet with calcium citrate supplementation. The satisfactory response rate was 15 and 30%, respectively. The presence of ‘complicated vestibulitis’, candidiasis concomitant with vestibulitis, decreases the satisfactory response rate regardless of the type of treatment administered (odds ratio 19.9, 95% CI 1.6, 250). <i>Conclusion:</i> Prolonged oral fluconazole is an ineffective treatment of vestibulitis, whether pure or complicated by concomitant vulvovaginal candidiasis. The coexistence of candidiasis and vestibulitis – complicated vestibulitis – might represent a subset of vestibulitis that is resistant to the currently available medical therapy.