Effects of Acetic Acid Vaginal Gel on Vulvovaginal Candidiasis: A Double Blind Randomized Controlled Trial

Background and purpose: It is estimated that 70–75% of women experience one episode of vulvovaginal candidiasis (VVC) during childbearing age and 40-50% suffer from recurrent VVC. Because of the resistance of Candida species to certain drugs, such as azoles, physicians tend to use complementary or alternative medicine such as vinegar in treatment of VVC. The current study aimed to determine the therapeutic effects of acetic acid vaginal gel on VVC. Materials and methods: A double-blind randomized clinical trial was done in women (n=41) with VVC in Sari, Iran. The patients were allocated into two treatment groups to receive either 2% acetic acid vaginal gel + 2% acetic acid intravaginal wash + clotrimazole vaginal cream (n=20) or 2% acetic acid intravaginal wash + clotrimazole vaginal cream (n=21) for 10 days. After treatment, clinical symptoms and mycological cure rate were assessed by culture of vaginal secretions. All yeast isolates were identified by molecular method. Results: Before the intervention, there were no significant differences in signs and symptoms (P= 0.703), fungal burden rate (low, medium, heavy) (P= 0.092), and causative Candida species (P= 0.188) between the two groups. After treatment, an improvement in symptoms was seen in case group but the difference was not significant (P =0.3512). A significant difference was found between the two groups in mycological cure rate (P= 0.0377). Candida albicans were the most common species causing the disease. Conclusion: The study showed that acetic acid vaginal gel could have a significant effect on the definitive cure of VVC.   (Clinical Trials Registry Number: IRCT20190309042978N3)