In countries with western lifestyle and nutrition, the majority of the population carry Candida in the gut. This should be considered normal and there is no evidence that elimination of the yeast makes sense or is even possible. In certain medical situations, however, prophylactic antifungal treatment to prevent the occurrence of a defined organ or systemic outbreak has been shown to be of benefit.
Under normal circumstances skin manifestations of candidosis seem to be easily treated, but only very limited information is available from studies. In other organ manifestations RCTs often fail to show significant differences between the different regimens and the results of placebo treatments are often surprisingly good, demonstrating that many patients have effective defence systems against the yeasts. Nevertheless, recalcitrant manifestations of local candidosis are frequent and may be a therapeutic problem since many RCTs show good short-term symptom relief but evidence of frequent recurrence in the long term.
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