“RANDOMIZED CONTROL TRIAL ON SYSTEMIC USE OF ITRACONAZOLE VERSUS TERBINAFINE IN VULVOVAGINAL CANDIDIASIS”
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 7, Pages 2384-2390
AbstractVagina is generally distinguished by relationships between Lactobacillus acidophilus and the metabolic by products of endogenous flora, oestrogen, vaginal pH and glycogen. L. acidophilus keeps the vaginal pH acidic by producing hydrogen peroxide, which is harmful to the pathogens. 
The species of Candida are found commonly in the healthy vagina in lesser amount. When any imbalance happens, like change in pH of vagina, hormonal balance, there is multiplication of Candida.
After bacterial vaginosis, the next most common cause of vaginal infection is vulvovaginal candidiasis. Around 75% female face minimal single episode of vulvovaginal candidiasis in their period of fertility. 
The most common cause of vulvovaginal candidiasis is Candida albicans (85-90%) and other causes include Candida glabrata, Candida guilliermondii, Candida krusei and Candida tropicalis.
Around 21-32% of healthy women are carriers of asymptomatic vaginal infection. Pregnant females, females treated with antibiotics previously and females with diabetes mellitus showed increased rates of colonisation.  In immunodeficient females, Candidiasis was found to be the most familiar opportunistic fungal infection. 
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