Longitudinal investigation of Candida vaginitis in pregnancy: Role of superimposed antibiotic use

doi:10.1016/S0029-7844(97)00581-4

Obstetrics & Gynecology

Volume 91, Issue 1, January 1998, Pages 115-118

https://doi.org/10.1016/S0029-7844(97)00581-4 Get rights and content

Objective

To evaluate the purported association of antibiotic use and subsequent symptomatic Candida vaginitis among pregnant women.

Methods

Two hundred fifty obstetric patients were followed in a prospective, culture-based, longitudinal, and observational study from the first antepartum appointment through the postpartum visit at 6 weeks. All patients were cultured for yeast (Nickerson agar) initially. Patients with symptoms and microscopic evidence of vaginitis at the initial visit were followed through pregnancy but were not analyzed with asymptomatic individuals who had vaginal cultures for Candida at the first visit and at subsequent visits if they developed vulvovaginal symptoms. Patients were categorized as colonized or uncolonized on the basis of initial cultures and were evaluated at least monthly for antibiotic use and vaginal complaints. In addition, hospital records were reviewed after the final visit to document antibiotic use or vaginal infection.

Result

Asymptomatically colonized patients were at a threefold greater risk of developing symptoms than were uncolonized patients (P < .001). Among women receiving antibiotics during pregnancy, 6.1% developed symptoms of Candida vaginitis compared with 15.6% of women who did not receive antibiotics. For the entire study population, 46% of the patients received at least one course of antibiotic therapy and 21% had multiple courses. Only three of the seven who became symptomatic with yeast vaginitis did so within 4 weeks of treatment. Many of the antibiotic regimens were prescribed by providers other than the obstetrician.

Conclusion

Antibiotic treatment during pregnancy was frequent in the study population, but was not associated with a significant risk of developing Candida vaginitis.

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Vaginal moniliasis after tetracycline therapy. The effects of amphotericin B
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There are more references available in the full text version of this article.

Cited by (22)

Associations with asymptomatic colonization with candida in women reporting past vaginal candidiasis: An observational study
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Citation Excerpt :
Positive results for Candida spp. were found in 37% of our sample of 192 asymptomatic women aged under 50 years. This is at the higher end of previous point prevalence studies [2–6], and higher than the 21% reported in another Melbourne sample with a demographically similar population five years earlier [5]. A previous study identified that reporting an episode of VVC in the previous 12 months was predictive of positive candida culture in (symptomatic) women [10], and as we deliberately sampled for women with past history of VVC, this may explain the difference.
Asymptomatic vaginal colonization with Candida species is a known risk factor for vulvovaginal candidiasis (VVC). Taking known risk factors for symptomatic VVC, the authors sought to identify factors associated with asymptomatic colonization.
As part of a randomized controlled trial which compared vaginal candidal colony counts in women taking garlic tablets or placebo, 192 asymptomatic women collected a baseline screening swab for Candida species. Eligibility for this study included at least one self-reported episode of VVC in the previous 12 months and age 18–50 years. Known risk factors for VVC were compared in women colonized with candida and those without colonization.
37% of asymptomatic women who self-reported VVC in the previous 12 months were colonized with vaginal Candida species. Using multivariate analysis, two factors were associated with asymptomatic colonization: a current sexual partner (P = 0.02) and being born outside of Australia (P = 0.05). Use of oral contraceptives was not statistically significant (P = 0.27).
Clinical relevance of asymptomatic colonization with vaginal yeast and its link to episodes of VVC warrants further investigation.
Prescription, over-the-counter, and herbal medicine use in a rural, obstetric population
2003, American Journal of Obstetrics and Gynecology
Citation Excerpt :
Pregnant women frequently take medications that are prescribed by physicians other than the obstetrics care provider. In a study of antibiotic usage by pregnant women, Glover and Larsen6 reported that emergency and family medicine physicians prescribed approximately 40% of the antibiotics that are consumed by obstetric patients. Women who take long-term medications (such as thyroxin, antihistamines, or psychotropic agents) may not inform the obstetrician about their use.
Objective: The purpose of this study was to identify the medications that are consumed by a rural obstetric population during pregnancy. Study Design: Over a period of 26 months, pregnant women were interviewed about medication use. Interviews on subsequent visits provided a longitudinal study of medication usage and discontinuation. Trend differences were analyzed according to the number of medications, the trimester of use, and insurance status. Results: Five hundred seventy-eight participants had 2086 interviews. The compilation of the interviews showed that 95.8% of the participants took prescription medications, 92.6% of the participants self-medicated with over-the-counter medications, and 45.2% of the participants used herbal medications. Over time, consumption of over-the-counter medications exceeded prescription medication use. Fifteen percent of the pregnant women took ibuprofen at some point during the pregnancy (5.7% in the third trimester). Eight percent of the women were noncompliant and 20% incompletely compliant with prenatal vitamin and mineral formulations. Conclusion: Medication use was substantial in this population. Medications (eg, ibuprofen) that are contraindicated in pregnancy were used at unexpectedly high rates. Of the three medication classes, over-the-counter medications were used most frequently. (Am J Obstet Gynecol 2003;188:1039-45.)
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2022, Medical Mycology
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2019, Current Infectious Disease Reports
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2017, Asian Pacific Journal of Reproduction
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2012, Archives of Gynecology and Obstetrics

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Longitudinal investigation of Candida vaginitis in pregnancy: Role of superimposed antibiotic use

Objective

Methods

Result

Conclusion

Am J Obstet Gynecol

Vaginal colonization or infection with Candida albicans in human immunodeficiency virus-infected patients during pregnancy and during the postpartum period

Clin Infect Dis

Vaginal moniliasis after tetracycline therapy. The effects of amphotericin B

Am J Obstet Gynecol