Effect of antibiotic use on the prevalence of symptomatic vulvovaginal candidiasis

OBJECTIVE: The purpose of the study was to evaluate the influence of antibi otic use on the prevalence of symptomatic vulvovaginal candidiasis. STUDY DESIGN: This is a case-control study of 684 women with symptomatic vu lvovaginal candidiasis who were enrolled at a vaginitis clinic and 901. con trol subjects who attended a cytologic screening service. RESULTS: The prevalence of antibiotic use in the month preceding the visit was 19.3% (132/684) among patients with Candida infection compared with 11. 9% (107/901) among control subjects (P < .001). After adjustment by logisti c regression for potential confounders (age, marital status, and contracept ive method used), the odds ratio for vulvovaginal candidiasis among patient s who reported antibiotic use in the month preceding the visit was 1.75 (95 % confidence interval 1.33 to 2.32). No differences in risk were found by t ype of antibiotic used. The likelihood of vulvovaginal candidiasis was dire ctly related to the duration of antibiotic use and was higher in patients w ho had a history of repeated episodes of Candida vaginal infection. CONCLUSIONS: Antibiotic use is a short-term risk factor for symptomatic vul vovaginal candidiasis, either as a first episode or in the form of recurren ce. Increasing duration of antibiotic use is directly related with an incre ased prevalence of Candida Vaginal infection.