Over-the-counter antifungal drug misuse associated with patient-diagnosed vulvovaginal candidiasis

Daron Gale Ferris, Paul Nyirjesy, Jack D. Sobel, David Soper, Adriana Pavletic, Mark S. Litaker

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Abstract

To estimate what proportion of symptomatic women purchasing over-the-counter antifungal products for immediate treatment of presumed vulvovaginal candidiasis have vulvovaginal candidiasis or other genitourinary conditions. A time-location sample of 95 symptomatic women who purchased and presented with an over-the-counter antifungal product for immediate and personal treatment of presumed vulvovaginal candidiasis were evaluated by clinical examination and pertinent laboratory tests. The percentage of women diagnosed having vulvovaginal candidiasis or other conditions, proportions of women with vulvovaginal candidiasis compared between groups with and without a prior diagnosis of vulvovaginal candidiasis, and groups that read or did not read the over-the-counter package label were assessed. The actual diagnoses for women who self-diagnosed vulvovaginal candidiasis were: vulvovaginal candidiasis 33.7%, bacterial vaginosis 18.9%, mixed vaginitis 21.1%, normal 13.7%, other diagnoses 10.5%, and trichomonas vaginitis 2.1%. Women with a previous clinically based diagnosis of vulvovaginal candidiasis were not more accurate in diagnosing vulvovaginal candidiasis than women without a prior clinical diagnosis (χ2 = 0.27, P = .6). Women who read the package label were no more likely to have vulvovaginal candidiasis than were women who did not read the label (Fisher exact test, P = .39). Many women who self-diagnose and use an over-the-counter product for treatment of presumed vulvovaginal candidiasis do not have vulvovaginal candidiasis. A history of a previous clinically based diagnosis of vulvovaginal candidiasis and reading the package label do not help women self-diagnose vulvovaginal candidiasis properly. Ready access to these products is associated with wasted financial expenditures, unfulfilled expectations, and a delay in correct diagnosis for a substantial number of women.

Original languageEnglish (US)
Pages (from-to)419-425
Number of pages7
JournalObstetrics and Gynecology
Volume99
Issue number3
DOIs
StatePublished - Mar 12 2002

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Vulvovaginal Candidiasis
Nonprescription Drugs
Trichomonas Vaginitis
Vaginitis
Bacterial Vaginosis

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Over-the-counter antifungal drug misuse associated with patient-diagnosed vulvovaginal candidiasis. / Ferris, Daron Gale; Nyirjesy, Paul; Sobel, Jack D.; Soper, David; Pavletic, Adriana; Litaker, Mark S.

In: Obstetrics and Gynecology, Vol. 99, No. 3, 12.03.2002, p. 419-425.

Research output: Contribution to journalArticle

Ferris, Daron Gale ; Nyirjesy, Paul ; Sobel, Jack D. ; Soper, David ; Pavletic, Adriana ; Litaker, Mark S. / Over-the-counter antifungal drug misuse associated with patient-diagnosed vulvovaginal candidiasis. In: Obstetrics and Gynecology. 2002 ; Vol. 99, No. 3. pp. 419-425.
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abstract = "To estimate what proportion of symptomatic women purchasing over-the-counter antifungal products for immediate treatment of presumed vulvovaginal candidiasis have vulvovaginal candidiasis or other genitourinary conditions. A time-location sample of 95 symptomatic women who purchased and presented with an over-the-counter antifungal product for immediate and personal treatment of presumed vulvovaginal candidiasis were evaluated by clinical examination and pertinent laboratory tests. The percentage of women diagnosed having vulvovaginal candidiasis or other conditions, proportions of women with vulvovaginal candidiasis compared between groups with and without a prior diagnosis of vulvovaginal candidiasis, and groups that read or did not read the over-the-counter package label were assessed. The actual diagnoses for women who self-diagnosed vulvovaginal candidiasis were: vulvovaginal candidiasis 33.7{\%}, bacterial vaginosis 18.9{\%}, mixed vaginitis 21.1{\%}, normal 13.7{\%}, other diagnoses 10.5{\%}, and trichomonas vaginitis 2.1{\%}. Women with a previous clinically based diagnosis of vulvovaginal candidiasis were not more accurate in diagnosing vulvovaginal candidiasis than women without a prior clinical diagnosis (χ2 = 0.27, P = .6). Women who read the package label were no more likely to have vulvovaginal candidiasis than were women who did not read the label (Fisher exact test, P = .39). Many women who self-diagnose and use an over-the-counter product for treatment of presumed vulvovaginal candidiasis do not have vulvovaginal candidiasis. A history of a previous clinically based diagnosis of vulvovaginal candidiasis and reading the package label do not help women self-diagnose vulvovaginal candidiasis properly. Ready access to these products is associated with wasted financial expenditures, unfulfilled expectations, and a delay in correct diagnosis for a substantial number of women.",
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