A change in policy may be helping to drive a rise in treatment-resistant vaginal thrush, amid significant yearly increases in the prevalence of fungal infections caused by fungal Candida species, suggests the first study of its kind, published online in the journal Sexually Transmitted Infections . While the exact reasons for these trends aren't yet clear, they follow a shift in clinical practice, with the aim of reducing laboratory workload, say the researchers. Family doctors in primary care are now encouraged to treat vaginal thrush empirically—on signs and symptoms alone, rather than on confirmatory lab test results.
Vaginal thrush is common, with three in every four women of reproductive age likely to be affected, note the researchers. In around one in 10 women, these infections are recurrent—defined as at least four episodes within 12 months. Resistance or lack of sensitivity to the mainstay of antifungal treatment (azoles) in Candida specimens from patients with a vaginal infection has been reported in other countries.
This has also been noted in the UK, but only in specialist clinics, explain the researchers. To obtain a more evidence-based picture of resistance levels and analyze wider trends, the researchers reviewed the culture results of 5461 vaginal swabs previously taken from women with suspected complicated or recurrent yeast infection in Leeds, northern England, between April 2018 and March 2021. Around a third (1828; 33.
5%) grew yeasts, most of which (85%.