{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T15:27:54Z","timestamp":1786116474375,"version":"build-2736575974"},"reference-count":23,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background: Vulvovaginal candidiasis, bacterial vaginosis, and mixed vaginal infection are among the most common infectious conditions encountered in gynecological practice. Although intravaginal dequalinium chloride exhibits broad antimicrobial activity, real-world longitudinal data describing treatment-associated clinical and microscopic changes remain limited, particularly in Latin American populations. Objective: We aimed to characterize the short-term longitudinal evolution of clinical manifestations, vaginal pH, and fresh wet-mount microscopic findings in women with vulvovaginal candidiasis, bacterial vaginosis, and mixed vaginal infection treated with intravaginal dequalinium chloride during routine outpatient gynecological care. Methods: This retrospective longitudinal study included non-pregnant women with vulvovaginal candidiasis, bacterial vaginosis, or mixed vaginal infection who received intravaginal dequalinium chloride as the sole anti-infective therapy. Patients were evaluated at baseline, treatment completion (Day 7), and post-treatment follow-up (Day 14). Longitudinal assessment included patient-reported symptoms, physician-assessed clinical findings, vaginal pH, and fresh wet-mount microscopic examination. To ensure consistent evaluation across study visits, predefined protocol-based standardized assessment criteria were applied uniformly to all patients. Repeated-measures non-parametric analyses were performed to compare longitudinal changes over time. Results: Sixty-nine women were included, comprising those with vulvovaginal candidiasis (n = 24), bacterial vaginosis (n = 31), and mixed vaginal infection (n = 14). Significant longitudinal improvement was observed in clinical manifestations, vaginal pH, and fresh microscopic findings across all diagnostic groups (all p &lt; 0.0001). Median composite assessment scores decreased from 8 (IQR 6\u201310) at baseline to 3 (IQR 1\u20135) at treatment completion and to 1 (IQR 0\u20133) at post-treatment follow-up. Improvements in vaginal pH were accompanied by reductions in inflammatory and infection-associated microscopic findings and by increased predominance of D\u00f6derlein bacilli during follow-up. Intravaginal dequalinium chloride was generally well tolerated, with only mild transient adverse events documented. Conclusions: In this retrospective longitudinal study, intravaginal dequalinium chloride treatment was associated with short-term changes in clinical manifestations, vaginal pH, and fresh microscopic findings among women with vulvovaginal candidiasis, bacterial vaginosis, and mixed vaginal infection. These findings describe short-term treatment-associated changes observed in routine clinical practice but do not establish comparative efficacy, causality, or microbiological cure. Prospective controlled studies incorporating standardized microbiological endpoints and longer follow-up are warranted to confirm these observations.<\/jats:p>","DOI":"10.3390\/jcm15156115","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T09:46:38Z","timestamp":1786009598000},"page":"6115","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Longitudinal Clinical and Microscopic Findings After Dequalinium Chloride Treatment in Vulvovaginal Infections: A Retrospective Real-World Study from Mexican Gynecological Practice"],"prefix":"10.3390","volume":"15","author":[{"given":"Gerardo","family":"Casanova-Rom\u00e1n","sequence":"first","affiliation":[{"name":"Cell Biology and Medical Histology, Saint Luke School of Medicine, Mexico City 11000, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina","family":"Navarro-Venegas","sequence":"additional","affiliation":[{"name":"Gynecology and Obstetrics, Angeles Hospital, Mexico City 11800, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ver\u00f3nica","family":"\u00c1valos-L\u00f3pez","sequence":"additional","affiliation":[{"name":"Gynecology and Obstetrics, Angeles Hospital, Mexico City 11800, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cinthya","family":"Verver-Moreno","sequence":"additional","affiliation":[{"name":"Gynecology and Obstetrics, Angeles Hospital, Mexico City 11800, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7405-4875","authenticated-orcid":false,"given":"Henry","family":"Velazquez-Soto","sequence":"additional","affiliation":[{"name":"Department of Immunology and Research Unit, Institute of Ophthalmology \u201cConde de Valenciana Foundation\u201d, Mexico City 06800, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nataly","family":"Arellano-Contreras","sequence":"additional","affiliation":[{"name":"Department of Non-Ophthalmological Emergencies and Research Unit, Institute of Ophthalmology \u201cConde de Valenciana Foundation\u201d, Mexico City 06800, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9826-8234","authenticated-orcid":false,"given":"Isabel","family":"Garza Ramos Raya","sequence":"additional","affiliation":[{"name":"Department of Non-Ophthalmological Emergencies and Research Unit, Institute of Ophthalmology \u201cConde de Valenciana Foundation\u201d, Mexico City 06800, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-0399-651X","authenticated-orcid":false,"given":"Israel","family":"Casanova-M\u00e9ndez","sequence":"additional","affiliation":[{"name":"Cell Biology and Medical Histology, Saint Luke School of Medicine, Mexico City 11000, Mexico"},{"name":"Department of Immunology and Research Unit, Institute of Ophthalmology \u201cConde de Valenciana Foundation\u201d, Mexico City 06800, Mexico"},{"name":"Department of Non-Ophthalmological Emergencies and Research Unit, Institute of Ophthalmology \u201cConde de Valenciana Foundation\u201d, Mexico City 06800, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the AMEGINE Clinical Research Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"S3","DOI":"10.1089\/pop.2020.0265","article-title":"Improving the Diagnosis of Vulvovaginitis: Perspectives to Align Practice, Guidelines, and Awareness","volume":"23","author":"Brown","year":"2020","journal-title":"Popul. Health Manag."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Sobel, J.D., and Vempati, Y.S. (2024). Bacterial Vaginosis and Vulvovaginal Candidiasis Pathophysiologic Interrelationship. Microorganisms, 12.","DOI":"10.3390\/microorganisms12010108"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.15585\/mmwr.rr7004a1","article-title":"Sexually Transmitted Infections Treatment Guidelines, 2021","volume":"70","author":"Workowski","year":"2021","journal-title":"MMWR Recomm. Rep."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Yalew, G.T., Muthupandian, S., Hagos, K., Negash, L., Venkatraman, G., Hagos, Y.M., Meles, H.N., Weldehaweriat, H.H., Al-Dahmoshi, H.O., and Saki, M. (2022). Prevalence of bacterial vaginosis and aerobic vaginitis and their associated risk factors among pregnant women from northern Ethiopia: A cross-sectional study. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0262692"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1093\/infdis\/jiw121","article-title":"Pathogenesis of Bacterial Vaginosis: Discussion of Current Hypotheses","volume":"214","author":"Muzny","year":"2016","journal-title":"J. Infect. Dis."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1399","DOI":"10.1093\/infdis\/jiz342","article-title":"An Updated Conceptual Model on the Pathogenesis of Bacterial Vaginosis","volume":"220","author":"Muzny","year":"2019","journal-title":"J. Infect. Dis."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1961","DOI":"10.1016\/S0140-6736(07)60917-9","article-title":"Vulvovaginal candidosis","volume":"369","author":"Sobel","year":"2007","journal-title":"Lancet"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"4680","DOI":"10.1073\/pnas.1002611107","article-title":"Vaginal microbiome of reproductive-age women","volume":"108","author":"Ravel","year":"2011","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1097\/GCO.0000000000000976","article-title":"Unravelling the vaginal microbiome, impact on health and disease","volume":"36","author":"Plummer","year":"2024","journal-title":"Curr. Opin. Obstet. Gynecol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e248661","DOI":"10.1001\/jamanetworkopen.2024.8661","article-title":"Efficacy of Dequalinium Chloride vs Metronidazole for the Treatment of Bacterial Vaginosis: A Randomized Clinical Trial","volume":"7","author":"Raba","year":"2024","journal-title":"JAMA Netw. Open"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1007\/s00404-015-3914-8","article-title":"Use of locally delivered dequalinium chloride in the treatment of vaginal infections: A review","volume":"293","author":"Mendling","year":"2016","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1159\/000332398","article-title":"A Comparison of Dequalinium Chloride Vaginal Tablets (Fluomizin\u00ae) and Clindamycin Vaginal Cream in the Treatment of Bacterial Vaginosis: A Single-Blind, Randomized Clinical Trial of Efficacy and Safety","volume":"73","author":"Weissenbacher","year":"2012","journal-title":"Gynecol. Obstet. Investig."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"114467","DOI":"10.1016\/j.bcp.2021.114467","article-title":"Medicinal applications and molecular targets of dequalinium chloride","volume":"186","author":"Bailly","year":"2021","journal-title":"Biochem Pharmacol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1097\/LGT.0000000000000790","article-title":"Dequalinium Chloride for the Treatment of Vulvovaginal Infections: A Systematic Review and Meta-Analysis","volume":"28","author":"Eckel","year":"2024","journal-title":"J. Low. Genit. Tract. Dis."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Qi, W., Li, H., Wang, C., Li, H., Zhang, B., Dong, M., Fan, A., Han, C., and Xue, F. (2021). Recent Advances in Presentation, Diagnosis and Treatment for Mixed Vaginitis. Front Cell Infect. Microbiol., 11.","DOI":"10.3389\/fcimb.2021.759795"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Eleut\u00e9rio, J., Campaner, A.B., and De Carvalho, N.S. (2023). Diagnosis and treatment of infectious vaginitis: Proposal for a new algorithm. Front. Med., 10.","DOI":"10.3389\/fmed.2023.1040072"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"368","DOI":"10.3122\/jabfm.19.4.368","article-title":"Variability of Vaginal pH Determination by Patients and Clinicians","volume":"19","author":"Ferris","year":"2006","journal-title":"J. Am. Board Fam. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1055\/s-0031-1299955","article-title":"Local Treatment of Vaginal Infections of Varying Etiology with Dequalinium Chloride or Povidone Iodine","volume":"52","author":"Petersen","year":"2011","journal-title":"Arzneimittelforschung"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1517\/14656566.2014.881800","article-title":"Treatment of bacterial vaginosis: What we have and what we miss","volume":"15","author":"Donders","year":"2014","journal-title":"Expert Opin. Pharmacother."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1016\/j.resmic.2017.02.003","article-title":"The global health impact of vaginal dysbiosis","volume":"168","author":"Jespers","year":"2017","journal-title":"Res. Microbiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1856","DOI":"10.1093\/infdis\/jiv338","article-title":"Influence of Biofilm Formation by Gardnerella vaginalis and Other Anaerobes on Bacterial Vaginosis","volume":"212","author":"Machado","year":"2015","journal-title":"J. Infect. Dis."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1093\/cid\/civ353","article-title":"Biofilms: An Underappreciated Mechanism of Treatment Failure and Recurrence in Vaginal Infections","volume":"61","author":"Muzny","year":"2015","journal-title":"Clin. Infect. Dis."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Bradshaw, C.S., and Brotman, R.M. (2015). Making inroads into improving treatment of bacterial vaginosis\u2014Striving for long-term cure. BMC Infect. Dis., 15.","DOI":"10.1186\/s12879-015-1027-4"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/15\/6115\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T10:15:49Z","timestamp":1786011349000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/15\/6115"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,6]]},"references-count":23,"journal-issue":{"issue":"15","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["jcm15156115"],"URL":"https:\/\/doi.org\/10.3390\/jcm15156115","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,6]]}}}