Context

Pharmacy First. This codelist was developed within the Pharmacy First project as a control condition for analyses related to urinary tract infection (UTI) pathways. Vulvovaginal candidiasis was selected as a comparator condition because it commonly presents in primary care and community pharmacy settings but is clinically distinct from bacterial urinary tract infections. The codelist is intended for use in observational analyses evaluating prescribing patterns within Pharmacy First pathways.

Inclusion/exclusion criteria

The codelist includes SNOMED CT (UK Clinical Edition) codes representing vulvovaginal candidiasis and related candidal vulvovaginal infections likely to be diagnosed and managed in primary care or community pharmacy settings. Terms covering vaginal candidiasis, vulvovaginal thrush, candidal vulvitis, and candidal vulvovaginitis were included where clinically appropriate.

The following were excluded: Non-candidal vaginitis or vaginosis, Sexually transmitted infections , Urinary tract infections or cystitis codes, Non-specific genital symptoms without confirmed candidal diagnosis, Historical, screening, or administrative codes without evidence of active infection

Borderline cases

Codes describing non-specific vaginitis, genital irritation, or mixed vaginal infections were reviewed carefully because they may overlap clinically with vulvovaginal candidiasis or urinary symptoms. These codes were excluded unless candidal infection was explicitly specified. Recurrent candidiasis codes were included where they clearly represented active or ongoing vulvovaginal candidal disease.

Sensitivity vs specificity

The codelist was designed to prioritise specificity over sensitivity. The intention was to identify consultations highly likely to represent vulvovaginal candidiasis while minimising inclusion of other genital or urinary conditions that could overlap symptomatically with UTI presentations.

Additional information

This codelist was created using SNOMED CT UK Clinical Edition release 42.0.0 and is intended for evaluation purposes within the Pharmacy First project. Clinical review was undertaken to ensure consistency with primary care coding practices and the intended comparator role for UTI pathway analyses.