A New Therapy for Uncomplicated Vulvovaginal Candidiasis and Its Impact on Vaginal Flora

Guglielmo Stabile; Roberta Marie Gentile; Stefania Carlucci; Stefano Restaino; Francesco De Seta

doi:10.3390/healthcare9111555

A New Therapy for Uncomplicated Vulvovaginal Candidiasis and Its Impact on Vaginal Flora

Healthcare (Basel). 2021 Nov 16;9(11):1555. doi: 10.3390/healthcare9111555.

Authors

Guglielmo Stabile¹, Roberta Marie Gentile², Stefania Carlucci³, Stefano Restaino⁴, Francesco De Seta^{1

2}

Affiliations

¹ Institute for Maternal and Child Health IRCCS "Burlo Garofolo", 34137 Trieste, Italy.
² Department of Medicine, Surgery and Health Sciences, University of Trieste, 34127 Trieste, Italy.
³ Department of Obstetrics and Gynecology, Azienda Sanitaria Universitaria Giuliano-Isontina, San Polo Hospital, Gorizia-Monfalcone, 34149 Trieste, Italy.
⁴ Department of Maternal and Child Health, University-Hospital of Udine, P.le S. Maria della Misericordia n° 15, 33100 Udine, Italy.

Abstract

Background: An estimated 75% of women will have one episode of vulvovaginal candidiasis (VCC) during their lifetime, and 40-50% of these will experience further episodes. The high incidence of vulvovaginal candidiasis, combined with the problems of azole resistance and toxicity, highlights the necessity for new strategies for the treatment of this condition. In this context, natural compounds represent promising alternatives. Methods: We enrolled, between January 2020 and April 2021, forty women affected by uncomplicated vulvovaginal candidiasis. Women were divided into two groups. In the first group, we treated 20 women with clotrimazole daily administration for six days. In the second group, 20 women were treated with clotrimazole associated with Unilen^® Microbio+, a new product containing Saccharomyces cerevisiae, melatonin, and GLA-14. Women underwent a check at days 15, 30, and 90. A clinical and cultural examination were performed to establish the effect of the treatments on vaginal flora. Results: In the group treated with Unilen^® Microbio+, clinical and microbiological cure at 15 and 30 days was observed in 18 women (90%), compared with 16 women (80%) in the group treated only with clotrimazole. The efficacy of the association between clotrimazole and Unilen^® Microbio+ in these uncomplicated forms was therefore not inferior to the azole treatment alone. Only four women (20%) in the Unilen^® Microbio+ group presented symptomatic recurrences within the 3 months, compared with eight women (40%) in the clotrimazole-only group. Microscopic wet mount analysis at 1 and 3 months demonstrated a significant increase in lactobacillus count and a reduction in the polymorphonucleate cells in the Unilen^® Microbio+ group. Conclusions: Unilen^® Microbio+ supplementation was demonstrated to cure uncomplicated vulvovaginal candidiasis with clotrimazole, reducing recurrence and improving vaginal flora better than clotrimazole treatment alone.

Keywords: clotrimazole; probiotics; therapy; treatment; vaginal flora; vulvovaginal candidiasis.