The efficacy and safety of current treatment of vulvovaginal candidiasis: An umbrella review of systematic reviews and meta-analyses.

Vulvovaginal candidiasis (VVC) is one of the most common infections of the genital tract in women of reproductive age. In this umbrella review, we aim to summarize all the existing literature about different treatment strategies for vulvovaginal candidiasis. This umbrella review adhered to the PRISMA guidelines, systematically searching databases including Scopus, PubMed, and Web of Science for meta-analyses for assessing different treatment methods for vaginal candidiasis until September 2024. Data extraction focused on outcome metrics, and methodological quality assessed via the AMSTAR-2 checklist. In our study, we have included a total of five articles. Within pharmacological interventions, treating individuals with fluconazole, ketoconazole, clotrimazole, and oteseconazole has demonstrated a significant reduction in the risk of mycological recurrence at the 12-month mark. Moreover, women who were treated with fluconazole experienced fewer episodes of VVC recurrence immediately after treatment, as well as at the 3- and 6-month follow-up periods when compared to those who received a placebo. In terms of non-pharmacological interventions, the combination therapy involving Redcore lotion alongside miconazole exhibited more substantial results in decreasing episodes of VVC compared to miconazole used alone. Furthermore, our results revealed a negative correlation between probiotic consumption and the rate of recurrence. In the end, we examined the primary treatment methods for vulvovaginal candidiasis and highlighted that, apart from azoles and antibiotics, emerging treatments such as probiotics and Redcore, along with certain established antibiotics, can also be considered viable options. More studies are needed to find more effective treatments as well as treatments for specific conditions such as pregnancy or immunodeficiency.