The efficacy of the boric acid-based maintenance therapy in preventing recurrent vulvovaginal candidiasis

Abstract

Current gold-standard treatment of recurrent vulvovaginal candidiasis (RVVC) is mainly based on maintenance with fluconazole. Moderate to high recurrence rates at long-term use and secondary fluconazole resistance emerge as reasons to seek for new topical maintenance regimens. In this study, it is aimed to assess the efficacy and safety of boric acid-based treatment approach to treat clinical RVVC. In this retrospective study, patients who were diagnosed with RVVC received a treatment package for six months that consist of induction with boric acid vaginal suppositories 600 mg daily for 14 nights followed by maintenance for five nights starting with every fifth day of the menstrual cycles; a vaginal estriol-lactobacilli combination; and several rigorous life-style changes. The success was defined as the absence of symptomatic recurrence during the follow-up. Success rate at the first year was found to be 94.8% in a total of 173 patients. Mild, reversible side effects were observed in five patients (2.9%). Boric acid, along with a vaginal estriol-lactobacilli combination and lifestyle changes can be a safe and effective alternative in lieu of potent systemic antifungal drugs as a first-line treatment for the patients referred with RVVC.