Assessing the treatment effect of cranberry type A proanthocyanidins on vulvovaginal candidiasis:a randomised controlled clinical interventional study

Objective This study aimed to evaluate the efficacy and safety of cranberry extracts:A-type proanthocyanidins(A-PACs)in the treatment and prevention of vulvovaginal candidiasis(WC).Method An open,randomised,parallel-design study was conducted.A cohort of 300 eligible patients with WC was recruited from the hospital.All participants were randomly divided into three groups according to a computergenerated randomisation list.Patients in group 1 were treated with standard antifungal therapy(oral single-dose fluconazole 150mg and vaginal miconazole suppository 400 mg at bedtime for 3 days);patients in group 2 received oral A-PACs16mLtwo times perdayfor6days basedon the treatment regimen of group 1;patients in group 3 were given oral A-PACs 16 mL two times per day for 6 days and vaginal miconazole suppository 400mg at bedtime for 3 days.Patients who were clinically cured at the seventh day of follow-up in group 2 received maintenance therapy by oral A-PACs for 12 weeks.Result At the seventh day of follow-up,the vaginal mycological results of all patients in group 2 who initially tested positive for pseudohyphae exhibited negative results.The negative conversion rates of fungal spores and blastospores in group 2 were superior to those in both group 1 and group 3.The symptoms of patients in group 2 ameliorated conspicuously compared with those in group 1(p<0.05).The clinical cure rate of VC in both group 2 and group 3 was not inferior to group 1.Cox regression analysis showed maintenance therapy was not significantly associated with short-term recurrence(HR 0.44(0.11,1.67);p=0.23)but could significantly diminish the risk of long-term recurrence(HR 0.57(0.33,0.99);p<0.05).Conclusion This study revealed that A-PACs in cranberry juice combined with azole antibiotics can be used as a novel therapeutic option for the treatment and prevention of long-termrecurrenceof WC.Trial registration number ChiCTR2300076392.