Probiotics for the treatment of vulvovaginal candidiasis in nonpregnant women: a systematic review and meta-analysis of randomized controlled trials

作者：Rongdan Chen, Wei Qing, Nuo Xu, L. M. Wang, Zhenhua Chen, Muxuan Chen, Shenghai Wu · 发表于：American Journal of Obstetrics and Gynecology · 年份：2026 · DOI：10.1016/j.ajog.2026.01.009 · 被引用次数：3 · 研究领域：Reproductive tract infections research、Preterm Birth and Chorioamnionitis、Antifungal resistance and susceptibility

OBJECTIVE: Vulvovaginal candidiasis and recurrent vulvovaginal candidiasis significantly impair women's quality of life and psychological well-being. Although numerous randomized controlled trials have explored probiotics as alternative or adjunctive therapies, their clinical efficacy remains inconclusive. This meta-analysis systematically assessed the therapeutic value of probiotics for these infections among nonpregnant women. DATA SOURCES: Cochrane Library, PubMed, Embase, ClinicalTrials.gov, and Web of Science were searched from inception to October 12, 2025. STUDY ELIGIBILITY CRITERIA: Eligible studies were randomized controlled trials enrolling nonpregnant women with vulvovaginal candidiasis or recurrent vulvovaginal candidiasis. Three comparisons were analyzed: 1) probiotics combined with antifungal drugs vs antifungal drugs (with or without placebo), 2) probiotics alone vs antifungal drugs, and 3) probiotics alone vs placebo. The primary outcomes were cure and recurrence rate. STUDY APPRAISAL AND SYNTHESIS METHODS: Relative risk and 95% confidence interval were calculated using the Mantel-Haenszel method. Random-effects or fixed-effects models were applied depending on heterogeneity assessed by the chi-squared test. RESULTS: Fourteen studies met the inclusion criteria. In comparison 1, according to low and very low certainty evidence, combination therapy significantly improved short-term (<1 month) mycological cure (relative risk=1.19; 95% confidence interval, 1.03-1....