USE OF PROBIOTICS AS COMPLEMENTARY THERAPY FOR RECURRENT CANDIDIASIS

Abstract

Introduction: Recurrent vulvovaginal candidiasis (RVVC) is a recurrent condition that affects a sizable portion of women of reproductive age, negatively impacting their quality of life. Conventional treatment, based on oral or topical antifungals, has limitations, such as fungal resistance and frequent recurrences. In this context, probiotics have been investigated as a complementary therapeutic alternative, aiming to restore the vaginal microbiota and reduce infection recurrence. Objective: To evaluate the efficacy of probiotics as a complementary therapy in the management of recurrent vulvovaginal candidiasis. Methodology: A systematic search was conducted in the PubMed, BVS, LILACS and ScienceDirect databases, including randomized clinical trials and cohort studies published between 2020 and 2025. The descriptors used were "probiotics" AND "microbiota" AND "treatment outcome" AND "vulvovaginal candidiasis." Studies that evaluated the use of probiotics, alone or in combination with antifungal treatment, compared to placebo or conventional treatment were selected. Results and Discussion: Of the selected studies, most demonstrated that probiotic supplementation, especially those containing Lactobacillus strains (such as L. rhamnosus GR-1 and L. reuteri RC-14), promoted the restoration of a healthy vaginal microbiota, increased lactobacillus colonization, and reduced candidiasis recurrence by up to 50% compared to conventional treatment alone. Furthermore, a lower rate of adverse effects and good adherence to probiotic use were observed. However, there are still discrepancies regarding dose, duration of treatment, and routes of administration (oral versus vaginal). Evidence suggests benefits when used as adjuncts, but they do not replace antifungal treatment. Conclusion: The use of probiotics as adjunctive therapy in recurrent vulvovaginal candidiasis showed promising results, with a significant reduction in the recurrence rate and an improvement in the balance of the vaginal microbiota. Despite the positive findings, further large-scale clinical trials with standardized protocols are needed to solidify the clinical recommendation for its use.