"Not thrush again!" Women's experience of post-antibiotic vulvovaginitis

Marie V Pirotta, Jane M Gunn and Patty Chondros
Med J Aust 2003; 179 (1): 43-46.


Objectives: To examine the frequency of post-antibiotic vulvovaginitis (PAV); describe how women prevent and treat PAV; and determine whether concern about PAV affects their decisions about taking antibiotics.

Design: Cross-sectional survey using a written questionnaire.

Setting and participants: Five general practice waiting rooms in north-western Melbourne, in February 2000. 1298 women aged 18–70 years were surveyed.

Main outcome measures: Self-reported symptoms and management of vulvovaginitis and PAV.

Results: The response rate was 86%. Thirty-five per cent of women reported ever having PAV and 73% reported ever having symptoms suggestive of vulvovaginal candidiasis. Antifungal medications and lactobacillus products or yoghurt were most popular for both prevention (49%, 40%) and treatment (63%, 43%) of PAV. Other home remedies such as tea tree oil, vinegar, and dietary and clothing modification were infrequently used by the women surveyed. Twenty-three per cent of women who had taken antibiotics in the previous month had experienced symptoms of vulvovaginitis. Of women who had ever had vulvovaginitis, 35% were moderately to very concerned about developing PAV when prescribed antibiotics. Because of this concern, around a fifth of these women would not take prescribed antibiotics.

Conclusions: Concern about PAV affects women's decision-making regarding antibiotic use. Many women use unproven complementary therapies to prevent or treat PAV. When prescribing antibiotics, doctors should discuss the risks of PAV and its management with patients.

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  • Marie V Pirotta1
  • Jane M Gunn2
  • Patty Chondros3

  • Department of General Practice, University of Melbourne, Melbourne, VIC.



We wish to thank the General Practice Evaluation Program (GPEP) for funding this study, the reception staff and the women who participated at each of the practices, and the referees for their valuable comments.

Competing interests:

None identified.

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