Lactobacillus acidophilus supplementation exhibited an impact similar to Fluconazole for symptomatic relief in vulvovaginal candidiasis. However, it was less efficient in recurrence prevention.

In order to examine the impact of probiotics and Fluconazole on the recurrence and management of vulvovaginal candidiasis, a randomized controlled triple-blinded trial was carried out.

Overall, 80 married women between the age of 18 to 49 who had vulvovaginal candidiasis were included in the study. Using the blocked randomization approach, the volunteers were divided into 2 groups. The probiotic-treated group received 30 probiotic capsules containing 1 × 109 colony forming unit (CFU)/g Lactobacillus acidophilus (LA-5) along with 1 Fluconazole placebo capsule, while the Fluconazole-treated group received a single dosage of Fluconazole (150 mg) in addition to 30 probiotic placebo capsules.

Patients' samples were obtained to assess the microbiological tests and vaginal pH, before, 30-35 days, and 60-65 days following the commencement of the treatment. Prior to the intervention as well as the first and second follow-ups, an evaluation of the signs and symptoms was done. For data analysis, independent t, Fisher's exact, chi-square, and ANCOVA tests were utilized.

The incidence of negative cultures 30-35 days following treatment initiation did not statistically vary between both groups. However, the frequency of negative cultures 60 to 65 days post-initiation of therapy was considerably greater in the Fluconazole group than in the probiotic group.

The Fluconazole group experienced considerably less abnormal discharge, reduced vulvovaginal erythema in both the 1st and 2nd follow-ups, and less pruritus in the second follow-up than the probiotic group did. However, there was no clinically meaningful difference between the groups in terms of dyspareunia, dysuria, frequent urination, or burning.

Lactobacillus acidophilus use can decrease a wide array of Candida vaginitis symptoms, like Fluconazole, although it was less efficacious than the latter to prevent recurrence.