Abstract
Objective
The purpose of this study was to review the treatment outcome and safety of topical
therapy with boric acid and flucytosine in women with Candida glabrata vaginitis.
Study design
This was a retrospective review of case records of 141 women with positive vaginal
cultures of C glabrata at two sites, Wayne State University School of Medicine and Ben Gurion University.
Results
The boric acid regimen, 600 mg daily for 2 to 3 weeks, achieved clinical and mycologic
success in 47 of 73 symptomatic women (64%) in Detroit and 27 of 38 symptomatic women
(71%) in Beer Sheba. No advantage was observed in extending therapy for 14 to 21 days.
Topical flucytosine cream administered nightly for 14 days was associated with a successful
outcome in 27 of 30 of women (90%) whose condition had failed to respond to boric
acid and azole therapy. Local side effects were uncommon with both regimens.
Conclusions
Topical boric acid and flucytosine are useful additions to therapy for women with
azole-refractory C glabrata vaginitis.
Keywords
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References
- Candida glabrata: review of epidemiology, pathogenesis, and clinical disease with comparison to C albicans.Clin Microbiol Rev. 1999; 12: 80-96
- Vulvovaginal candidiasis: epidemiologic, diagnostic, and therapeutic considerations.Am J Obstet Gynecol. 1998; 178: 203-211
- Chronic vulvovaginal candidiasis: characteristics of women with Candida albicans, C glabrata and no candida.Genitourin Med. 1995; 71: 304-307
- Evolving pathogens in vulvovaginal candidiasis: implications for patient care.J Clin Pharmacol. 1992; 32: 248-255
- Torulopsis glabrata vaginitis.Obstet Gynecol. 1995; 85: 993-998
- Single oral dose fluconazole compared with conventional topical therapy of Candida vaginitis.Am J Obstet Gynecol. 1995; 172: 1263-1268
- Treatment of complicated Candida vaginitis: comparison of single and sequential doses of fluconazole.Am J Obstet Gynecol. 2001; 185: 363-369
- Comparative in vitro activity of antimycotic agents against pathogenic vaginal yeast isolates.J Med Vet Mycol. 1994; 32: 267-274
- Torulopsis glabrata vaginitis: clinical aspects and susceptibility to antifungal agents.Obstet Gynecol. 1990; 76: 651-655
- In vitro activities of ravuconazole and voriconazole compared with those of four approved systemic antifungal agents against 6,970 clinical isolates of Candida spp.Antimicrob Agents Chemother. 2002; 46: 1723-1727
- Treatment of Torulopsis glabrata vaginitis: retrospective review of boric acid therapy.Clin Infect Dis. 1997; 24: 649-652
- Topical flucytosine therapy for chronic recurrent Candida tropicalis infections.J Reprod Med. 1986; 31: 821-824
- Development of in vitro susceptibility testing criteria and quality control parameters: approved guidelines M 27-A.National Committee for Clinical Laboratory Standards, Villanova (PA)1994
- Antifungal agents vs. boric acid for treating chronic mycotic vulvovaginitis.J Reprod Med. 1991; 36: 593-597
- Combined topical flucytosine and amphotericin B for refractory vaginal Candida glabrata infections.Sex Transm Infect. 2001; 77: 212-213
- Echinocandins: a new class of antifungal.J Antimicrob Chemother. 2002; 49: 889-891
Article info
Publication history
Accepted:
May 30,
2003
Received in revised form:
April 8,
2003
Received:
January 28,
2003
Detroit, Mich, and Beer Sheva, IsraelIdentification
Copyright
© 2003 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
