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Boric acid for recurrent vulvovaginal candidiasis: the clinical evidence.
J Womens Health (Larchmt). 2011 Aug; 20(8):1245-55.JW

Abstract

BACKGROUND

Recurrent vulvovaginal candidiasis (VVC) remains a challenge to manage in clinical practice. Recent epidemiologic studies indicate that non-albicans Candida spp. are more resistant to conventional antifungal treatment with azoles and are considered as causative pathogens of vulvovaginal candidiasis.

METHODS

We searched PubMed and Scopus for studies that reported clinical evidence on the intravaginal use of boric acid for vulvovaginal candidiasis.

RESULTS

We identified 14 studies (2 randomized clinical trials [RCTs], 9 case series, and 4 case reports) as eligible for inclusion in this review. Boric acid was compared with nystatin, terconazole, flucytosine, itraconazole, clotrimazole, ketoconazole, fluconazole, buconazole, and miconazole; as monotherapy, boric acid was studied in 7 studies. The mycologic cure rates varied from 40% to 100% in patients treated with boric acid; 4 of the 9 included case series reported statistically significant outcomes regarding cure (both mycologic and clinical) rates. None of the included studies reported statistically significant differences in recurrence rates. Regarding the adverse effects caused by boric acid use, vaginal burning sensation (<10% of cases), water discharge during treatment, and vaginal erythema were identified in 7 studies.

CONCLUSIONS

Our findings suggest that boric acid is a safe, alternative, economic option for women with recurrent and chronic symptoms of vaginitis when conventional treatment fails because of the involvement of non-albicans Candida spp. or azole-resistant strains.

Authors+Show Affiliations

Alfa Institute of Biomedical Sciences, 9 Neapoleos Street, Marousi, Athens, Greece..No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

21774671

Citation

Iavazzo, Christos, et al. "Boric Acid for Recurrent Vulvovaginal Candidiasis: the Clinical Evidence." Journal of Women's Health (2002), vol. 20, no. 8, 2011, pp. 1245-55.
Iavazzo C, Gkegkes ID, Zarkada IM, et al. Boric acid for recurrent vulvovaginal candidiasis: the clinical evidence. J Womens Health (Larchmt). 2011;20(8):1245-55.
Iavazzo, C., Gkegkes, I. D., Zarkada, I. M., & Falagas, M. E. (2011). Boric acid for recurrent vulvovaginal candidiasis: the clinical evidence. Journal of Women's Health (2002), 20(8), 1245-55. https://doi.org/10.1089/jwh.2010.2708
Iavazzo C, et al. Boric Acid for Recurrent Vulvovaginal Candidiasis: the Clinical Evidence. J Womens Health (Larchmt). 2011;20(8):1245-55. PubMed PMID: 21774671.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Boric acid for recurrent vulvovaginal candidiasis: the clinical evidence. AU - Iavazzo,Christos, AU - Gkegkes,Ioannis D, AU - Zarkada,Ioanna M, AU - Falagas,Matthew E, Y1 - 2011/07/20/ PY - 2011/7/22/entrez PY - 2011/7/22/pubmed PY - 2012/1/18/medline SP - 1245 EP - 55 JF - Journal of women's health (2002) JO - J Womens Health (Larchmt) VL - 20 IS - 8 N2 - BACKGROUND: Recurrent vulvovaginal candidiasis (VVC) remains a challenge to manage in clinical practice. Recent epidemiologic studies indicate that non-albicans Candida spp. are more resistant to conventional antifungal treatment with azoles and are considered as causative pathogens of vulvovaginal candidiasis. METHODS: We searched PubMed and Scopus for studies that reported clinical evidence on the intravaginal use of boric acid for vulvovaginal candidiasis. RESULTS: We identified 14 studies (2 randomized clinical trials [RCTs], 9 case series, and 4 case reports) as eligible for inclusion in this review. Boric acid was compared with nystatin, terconazole, flucytosine, itraconazole, clotrimazole, ketoconazole, fluconazole, buconazole, and miconazole; as monotherapy, boric acid was studied in 7 studies. The mycologic cure rates varied from 40% to 100% in patients treated with boric acid; 4 of the 9 included case series reported statistically significant outcomes regarding cure (both mycologic and clinical) rates. None of the included studies reported statistically significant differences in recurrence rates. Regarding the adverse effects caused by boric acid use, vaginal burning sensation (<10% of cases), water discharge during treatment, and vaginal erythema were identified in 7 studies. CONCLUSIONS: Our findings suggest that boric acid is a safe, alternative, economic option for women with recurrent and chronic symptoms of vaginitis when conventional treatment fails because of the involvement of non-albicans Candida spp. or azole-resistant strains. SN - 1931-843X UR - https://www.unboundmedicine.com/medline/citation/21774671/Boric_acid_for_recurrent_vulvovaginal_candidiasis:_the_clinical_evidence_ DB - PRIME DP - Unbound Medicine ER -