Abstract
Background: Vulvovaginal candidiasis (VVC) is a common fungal infection of the vaginal
area affecting 75% of women at least once in their lifetime. However, there is no clear evidence helping
to choose the most effective treatment method to improve the symptoms of VVC.
Objective: The objective of this study was to compare the effect of using honey with clotrimazole on
the treatment of symptoms of VVC.
Methods: All databases in English (Embase, MEDLINE, ProQuest, Google Scholar, Scopus,
Cochrane Library, and Web of Science) and Persian (Irandoc, SID, and Magiran) were searched without
time limitation. Evaluation of studies in terms of bias was performed using the Cochrane handbook.
Four clinical trials were included in the present systematic review; however, only three of them
were included in the meta-analysis.
Results: The results of the meta-analysis demonstrated that the rate of positive culture after treatment
(RR: 2.35; 95%CI: 1.45 to 3.82) was significantly higher in the honey group than in the clotrimazole
one. The frequency of itching after treatment (RR: 0.25, 95%CI: 0.12 to 0.49) was significantly lower
in the honey-receiving group than in the clotrimazole one. However, there was no statistically significant
difference in the incidence of other symptoms of VVC, including vaginal discharge (RR: 0.26,
95%CI: 0.02 to 2.75), vaginal burning (RR: 0.35, 95%CI: 0.03 to 3.80) and dyspareunia (RR: 0.64,
95%CI: 0.27 to 1.50) between groups.
Conclusion: Due to the low quality of the studies, more clinical trial studies with stronger designs in
this field are needed to clearly identify the therapeutic effects of honey on improving the symptoms of
VVC.
Graphical Abstract
[15]
Workowski KA, Bolan GA. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep 2015; 64(Rr-03): 1-137.
[21]
Nwadioha S, Egah D, Alao O, Iheanacho E. Risk factors for vaginal candidiasis among women attending primary health care centers in Jos, Nigeria. J Clin Med Res 2010; 2(7): 111-3.
[24]
Jafarzadeh L, Separdar A, Lori Gavini Z, Rafiean M, Deris F, Shahinfard N. Effect of clotrimazole-satureja bachtiarica vaginal cream and clotrimazole vaginal cream in patients with vaginal candidiasis. Majallah-i Zanan, Mamai va Nazai-i Iran 2019; 21(11): 14-22.
[25]
Karimi FZ, Bakhshi M, Dadgar S, Maleki-Saghooni N. Review of anti-Trichomonas vaginalis herbs and their therapeutic effects. Majallah-i Zanan, Mamai va Nazai-i Iran 2018; 20(12): 96-109.
[29]
Eftekhari AD, Anvari M, Ranji N. Investigation of ERG11 gene mutations in fluconazole resistant Candida albicans isolated from a number of Rasht hospitals. Pathobiol Res 2015; 18(3): 98-107.
[30]
Fazel N, Hashemian M, Ramezani M, Akaberi A. Comparative effect alone honey and mix with chlotrimazol on vaginitis candidacies. Majallah-i Zanan, Mamai va Nazai-i Iran 2012; 14(8): 48-54.
[31]
Tajik-Ijdan F, Kazemi A, Nowrozi H. Comparing the effects of alcoholic extract of ginseng with itraconazole against Candida albicans and Candida krusei. Feyz J Kashan Univ Med Sci 2017; 21(3): 211-7.
[32]
Nobahar B, Javedanmehr M. Herbal medicines for treatment of antifungal and bacterial vaginitis in reproductive aged women: a systematic review and meta-analysis. National Academy of Managerial Staff of Culture and Arts Herald 2018; 2018(3): 462-7.
[35]
Yavarpour V, Zarabi M, Esmaeili D, Mohamadnejad J. In vitro evaluation of antibacterial efficacy of natural honeys in comparison with antibiotics on Pseudomonas aeruginosa. Iran J Med Microbiol 2014; 8(1): 34-7.
[36]
Clarke K, Warwick R. Changes in marine communities: An approach to statistical analyses and interpretation. Plymouth: Natural Environment Research Council 1994.
[53]
Mousavi MS, Keshavarz T, Montaseri H, et al. A comparative study on the therapeutic effect of the propolis vaginal cream and clotrimazole on candida vulvovaginitis in reproductive aged women. Majallah-i Danishkadah-i Pizishki-i Isfahan 2011; 28(117)
[54]
Rasooli T, Nahidi F, Mojab F, Nasiri M, Parsapour H. Effect of honey cinnamon vaginal cream and clotrimazole vaginal cream on improvement of candida vaginitis symptoms in women: randomized clinical trial. Majallah-i Zanan, Mamai va Nazai-i Iran 2019; 22(3): 59-67.