Practices of Lebanese gynecologists regarding treatment of recurrent vulvovaginal candidiasis

Abstract

Background: A review of the literature clearly indicates the absence of one set of guideline in the treatment of recurrent vulvovaginal candidiasis. In Lebanon, as physicians are trained in European or American schools of medicine, locally or abroad, they may be approaching the issue of recurrent vulvovaginal candidiasis using various methods.

Aims: A national survey was conducted among Lebanese gynecologists to assess therapeutic protocols most commonly adopted to treat recurrent vulvovaginal candidiasis.

Material and methods: All obstetricians-gynecologists registered with the Order of Physicians were targeted. Bivariate analyses, comparing groups with specific prescription preferences, were tested using relevant statistical tests. All variables with significant bivariate associations with the outcomes were initially planned for a multivariate regression analysis to assess their interactive effects.

Results: The study confirms that different approaches are used to treat recurrent vulvovaginal candidiasis. Most gynecologists (70%) recommended fluconazole 150 mg as first-line treatment. Fluconazole alone was significantly preferred by North American trained physicians, whereas European trained ones preferred to prescribe it in combination. However different dosage regimens were used with duration of treatment ranging from 2 to 4 weeks, with or without maintenance.

Conclusions: The study revealed large diversity in prescription pattern, closely related to the specialization background of the physician. There is a need to generate evidence to establish national guidelines.

Keywords: Fluconazole; Recurrent vulvovaginal candidiasis; Treatment patterns.