PDF(Pubmed)
Abstract：
Vulvovaginal candidiasis (VVC) is a common condition associated with discomfort in affected women. Due to the presence of different forms of the disease, diverse treatment regimens are developed; the newest ones include oteseconazole and ibrexafungerp. Here, we focus on the most up-to-date recommendations regarding VVC treatment, as well as novel treatment options. Topical and oral azoles are the drugs of choice in uncomplicated mycosis. The efficacy of probiotics and substances such as TOL-463 and chlorhexidine is indicated as satisfactory; however, there are no relevant guidelines. Although the majority of researchers agree that the treatment of non-albicans VVC should be long-lasting, the recommendations are inconsistent. Another clinical problem is the treatment of VVC with azole intolerance or resistance, for which literature proposes the use of several drugs including oteseconazole, ibrexafungerp, and voriconazole. The treatment schedules for recurrent VVC include mainly fluconazole; however, alternative options such as immunotherapeutic vaccine (NDV-3A) or designed antimicrobial peptides (dAMPs) were also described. We also focused on VVC affecting pregnant women, which is a substantial challenge in clinical practice, also due to the heterogeneous relevant guidelines. Thus far, few precise recommendations are available in the literature. Future studies should focus on atypical VVC forms to elucidate the inconsistent findings.
摘要：
外阴阴道念珠菌病（VVC）是受影响妇女不适的常见病。由于存在不同形式的疾病，开发了多种治疗方案；最新的治疗方案包括奥来替康唑和ibrexafungerp。这里,我们专注于关于VVC治疗的最新建议，以及新颖的治疗方案。局部和口服唑类药物是单纯性真菌病的首选药物。益生菌和TOL-463和氯己定等物质的功效令人满意；然而，没有相关的指导方针。尽管大多数研究人员同意非白色念珠菌VVC的治疗应该是持久的，建议不一致。另一个临床问题是治疗具有唑不耐受或耐药的VVC，文献建议使用几种药物，包括奥司康唑，Ibrexafungerp,和伏立康唑.复发性VVC的治疗方案主要包括氟康唑；然而，还描述了替代选择，例如免疫治疗疫苗（NDV-3A）或设计的抗菌肽（dAMP）。我们还关注影响孕妇的VVC，这在临床实践中是一个巨大的挑战，也是由于不同的相关指南。到目前为止,在文献中很少有精确的建议。未来的研究应侧重于非典型VVC形式，以阐明不一致的发现。
