OBJECTIVE: To monitor yeasts isolated from women during and between episodes of recurrent
vulvo-vaginal candidosis (VVC) to determine whether vaginal relapse or re-infection occurred.
METHODS:Women presenting at the genitourinary medicine clinic with signs and symptoms of VVC
were recruited to the study (n = 121). A vaginal washing, high vaginal swab (HVS) and rectal swab
were taken and the women treated with a single 500 mg clotrimazole pessary.Women were asked to
re-attend after 1, 4, and 12 weeks, or when the VVC recurred, when vaginal washings and HVS were
repeated. Candida isolates recovered were strain typed using the Ca3 probe and their similarity
assessed. Antifungal susceptibility to fluconazole and clotrimazole were determined.
RESULTS: Of the women recruited, 47 completed the study, either returning for four visits or suffering
a recurrence during the study period. Of the 22 women who experienced recurrence, the
same strain was responsible for the initial and recurrent episode in 17 women. For the remaining
five women, four had strain replacement and one had a change of species. None of the isolates
recovered from the women demonstrated resistance to either clotrimazole or fluconazole.
CONCLUSIONS: Our findings support the theory of vaginal relapse and thus may support the use
of more prolonged courses of antifungal therapy initially to increase the chances of eradication of
the yeast
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