From the Research
Maintenance treatment for desquamative inflammatory vaginitis (DIV) typically involves long-term use of clindamycin 2% vaginal cream or hydrocortisone vaginal suppositories, with the goal of preventing recurrence and improving quality of life. After initial intensive therapy, patients should transition to a maintenance regimen of clindamycin cream applied 2-3 times weekly or hydrocortisone suppositories 25mg 1-2 times weekly for several months, as supported by the study published in 2011 1. Some patients may require maintenance therapy for 6-12 months or longer to prevent recurrence, as noted in the study from 2014 2. The frequency can be gradually tapered based on symptom control, with some patients eventually needing only once-weekly applications. Regular follow-up visits every 3-6 months are recommended to assess response and adjust treatment as needed, taking into account the chronic nature of the condition and the potential for relapse, as discussed in the study from 2010 3. DIV is a chronic inflammatory condition affecting the vaginal epithelium, characterized by purulent discharge, vaginal erythema, and epithelial cell exfoliation, and the maintenance therapy works by continuing to suppress the inflammatory process and preventing the return of symptoms, as described in the study from 2022 4. Patients should be advised that premature discontinuation often leads to relapse, and some may require intermittent or continuous long-term therapy for optimal management.
Key considerations for maintenance treatment include:
- Long-term use of clindamycin 2% vaginal cream or hydrocortisone vaginal suppositories
- Gradual tapering of frequency based on symptom control
- Regular follow-up visits to assess response and adjust treatment
- Potential for relapse with premature discontinuation of treatment
- Importance of patient education on the chronic nature of the condition and the need for ongoing management.
The most recent and highest quality study, published in 2022 4, provides a comprehensive overview of the evaluation and management of vaginitis, including desquamative inflammatory vaginitis, and supports the use of maintenance therapy to prevent recurrence and improve quality of life.