Guest guest Posted January 7, 2004 Report Share Posted January 7, 2004 Don't know how many of you subscribe to OBGYNWorld.com, but this article was posted via my mail list today.... Regards Dusty Azole-refractory candidiasis treatment revealedSource: American Journal of Obstetrics and Gynecology 2003; 189: 1297-1300 Reviewing the efficacy and tolerability of topical therapy with boric acid and flucytosine in women with Candida glabrata vaginitis. Both flucytosine and boric acid appear to be effective therapies for women with azole refractory Candida glabrata vaginitis, research suggests. The most commonly reported non-albicans Candida infection, C. glabrata, is known to increase in vitro resistance to the entire class of azoles and polyene antifungal agents, making it unclear as to what is the most appropriate treatment, Jack Sobel (Wayne State University School of Medicine, Detroit, Michigan, USA) and colleagues observe. To investigate, they retrospectively reviewed the records of 141 women with positive vaginal cultures for C. glabrata. Treatment with boric acid, 600 mg/day, for 2 to 3 weeks, was associated with a clinical and mycological success rate of around 70 percent. Among those who failed to respond to boric acid and azole therapy, however, 90 percent responded to nightly flucytosine taken for 2 weeks. Side effects were uncommon with both regimens. Despite its higher efficacy, flucytosine is more expensive than boric acid, and resistance remains a concern, Sobel et al warn. On the other hand, "treatment with boric acid vaginal capsules offers a reasonable success rate and is inexpensive and safe," they comment. Posted: 7 January 2004 Quote Link to comment Share on other sites More sharing options...
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