Lactobacillus In Combination With Antifungal Treatment Compared With Antifungal Treatment Alone For Patients With Vulvovaginal Candidiasis:A Systematic Review

PURPOSE:This systematic review aimed to evaluate the efficacy and safety of antifungal treatment in combination with lactobacillus for the treatment of vulvovaginal candidiasis (VVC).METHODS:PubMed, EMBASE, the Cochrane Central Register of Trial, CBMdisc, CNKI, VIP and Wanfang Database were searched, without language limitations, for randomized controlled trials (RCTs), in which antifungal treatment in combination with lactobacillus were compared with antifungal treatment alone in patients with VVC. The major outcomes were cure rate and recurrence rate, the second outcomes were symptom remission rate, vaginal pH improvement rate, and side effects. Reviewer Manager software, ver.5.2, was used for meta-analysis.RESULTS:In this study,8RCTs,1102patients were included. We found that antifungal treatment in combination with lactobacillus showed advantage in improving cure rate (OR=3.40,95%CI:1.83～6.29, P=0.0001), decreasing recurrence rate (OR=0.17,95%CI:0.09～0.33, P<0.00001), improving symptom remission rate (OR=3.80,95%CI:1.47-9.82, P=0.006) over antifungal treatment alone. There was no significant difference between antifungal treatment in combination with lactobacillus and antifungal treatment alone in the vaginal pH improvement rate (OR=1.42,95%CI:0.31～6.62, P=0.65) and side effects.CONCLUSION:We concluded that in treating WC, antifungal treatment in combination with lactobacillus compared with antifungal treatment alone was more effective in improving cure rate, symptom remission rate and decreasing recurrence rate, and it’s safe. Therefore, it can be considered to be an effective clinical auxiliary therapy.