Abstract
Background: In addition to physical discomfort, recurrent vulvovaginal candidiasis imposes
a significant financial and psychosocial burden, such as lower levels of self-esteem, a higher level
of stress, clinical depression, and less satisfaction with their life. Recurrent vulvovaginal candidiasis
interferes with emotional and sexual relationships.
Objective: This study aimed to compare the effect of vaginal Salvia officinalis, clotrimazole, and their
combination on the prevention of recurrent vulvovaginal candidiasis.
Methods: This randomized triple-blinded trial was conducted on 111 women aged 18-49 years with
vulvovaginal candidiasis. Participants were randomly assigned into one of the three groups of vaginal
tablets of Salvia officinalis 400 mg and placebo of clotrimazole 100 mg, clotrimazole 100 mg and placebo
of Salvia officinalis 400 mg, or Salvia officinalis and clotrimazole that were applied every night
for 7 consecutive days. A recurrence rate of vulvovaginal candidiasis was evaluated by WET test and
vaginitis symptoms examination after 12 weeks. In the case of positive evaluation, the culture of vaginal
discharge was performed.
Results: Totally, 29 patients (80.6%) in group clotrimazole, 33 patients (94.3%) in group Salvia officinalis
and 35 patients (97.2%) in group Salvia officinalis-clotrimazole were treated (P = 0.43). Out of
cured patients, 4 (13.8%) patients in the group clotrimazole, 1 patient (3%) in group Salvia officinalis,
and no case in group Salvia officinalis-clotrimazole experienced the recurrence of infection. There was
a significant difference among the 3 groups in terms of recurrence (P = 0.023). Moreover, no adverse
event during the 12 weeks after treatment was observed.
Conclusion: Adjuvant therapy of Salvia officinalis alongside routine vaginal clotrimazole could successfully
prevent recurrent vulvovaginal candidiasis after three months.
Graphical Abstract
[3]
Decherney A, Nathan L, Laufer N, Roman A. Current diagnosis & treatment obstetrics and gynecology. (11th ed.), Columbus, Ohio: McGraw-Hill Companies 2013.
[5]
Tehrani R, Farahmand M, Abedini MZH. Prevalance of vaginitis in iranian women symtoms and clinical association. Med Sci J Islamic Azad Uni-Tehran Med 2012; 22(1): 62-8.
[6]
Namazi A, Sehati P, Adibpur M, Mazloomi AS, Mohammad Alizadeh S. Prevalence and risk factors for candidiasis infection in women referring to health centers of Tabriz. J Med Sci Health 2008; 15(1): 67-1.
[9]
Sobel JD. Recurrent vulvovaginal candidiasis. Am J Obs Gyn 2015; 214: 15-21.
[10]
Hong E, Dixit S, Fidel PL, Bradford J, Fischer G. Vulvovaginal candidiasis as a chronic disease: Diagnostic criteria and definition. J Low Genit Tract Dis 2014; 18: 31-8.
[13]
MacNeill C, Weisz J, Carey JC. Clinical resistance of recurrent Candida albicans vulvovaginitis to fluconazole in presence and absence of in vitro resistance. J Reprod Med 2003; 48: 63-8.
[15]
Lipsky MS, Waters T. The “Prescription-to-OTC switch” movement. Arch Fam Med 1999; 8: 297-300.
[17]
Odds FC. Candida and candidosis: A review and bibliography. (2nd ed.). Bailliere Tindall London 1988; p. 124.
[23]
Blumenthal M, Ed. The Complete German Commission E monographs Therapeutic guide to herbal medicines. Austin, TX: American Botanical Council 1998.
[26]
Nazari T. Comparison of itraconazole and clotrimazole in treatment of vulvo vaginal candidasis. Majallah-i Danishgah-i Ulum-i Pizishki-i Babul 2007; 8(6): 24-0.
[29]
Brojeni BSH, Mobini GR, Rafiyan Kopani M, Rasti Brojeni M, Sereshti M. The effect of Salvia officinalis extract and clotrimazole laboratory on vaginal candida isolated from women with vaginal candidiasis. Yafteh 2016; 17(1): 95-103.
[31]
Jasim R, Al-khaliq I. Inhibitory effect of aqueous Salvia officinalis’s leaves in the growth of Candida albicans from infected women with vaginal candidiasis. Al-Kindy College Med J 2011; 6: 47-9.
[38]
Hayouni EA, Chraief I, Abedrabba M, Bouix M, Leveau J-Y, Mohammed H. Tunisian Salvia officinalis L. and Schinus molle L.(2008). essential oils: Their chemical compositions and their preservative effects against Salmonella inoculated in minced beef meat. Int J Food Microbiol 2008; 125(3): 242-51.
[41]
Okuyama T, Matsuda M, Masuda Y, Baba M, Masubuchi H, Adachi M. Studies on cancer bio-chemoprevention of natural resources. X. Inhibitory effect of spices on TPA-enhanced 3H-choline incorporation in phospholipid of C3H10T1/2 cells and on TPA-induced ear edema. Zhonghua Yaoxue Zazhi 1995; 47(5): 421-30.
[44]
Atai Z, Ansari M, Ayatelahi Mousavi A, Mirzaei A. In-vitro study of antifungal effects of selected herbal extracts on standard and wild strains of Candida albicans. J Islam Dent Assoc Iran 2007; 19: 91-7. [In Persian]
,
Yousef Javadzadeh
Download PDF Flyer