Abstract
Therapy of chronic recurrent vulvovaginal can- didiasis (VVC) caused by Candida glabrata is still rare in comparison to C. albicans infection, but therapy remains more difficult. Combination therapy with topical antifungals may improve therapy outcome, but still standard agents as fluconazole or itraconazole often fail. Posaconazole is a new systemic triazole with a wide antifungal spectrum including rare Candida species. Up to now, no clinical trials with posa- conazole in chronic recurrent VVC have been undertaken. Here, first results of the application of a new therapy regimen consisting of oral posaconazole in combination with topical ciclopiroxolamine are presented. 15 patients with chronic recurrent VVC caused by C. glabrata have been treated. 14 of these patients experienced successful therapy, clinical and mycological cure 30 days after begin of therapy has been observed. Long-term results are promising, as in 4 patients clinical and mycologic cure persists for more than 1 year up to now.
Highlights
Vulvovaginal candidiasis (VVC) is termed chronic if it recurs four times or more per year at intervals of 8 weeks or less [1]
Though C. albicans is the main pathogen in more than 95% of cases of acute infection [4], other species are implicated in chronic infection, C. glabrata
Patients were eligible if they had a chronic vaginal candidiasis caused by C. glabrata, a history of therapy failure and reduced sensitivity towards licensed antifungals indicated by susceptibility testing
Summary
Vulvovaginal candidiasis (VVC) is termed chronic if it recurs four times or more per year at intervals of 8 weeks or less [1]. Literature data suggest that acute vulvovaginal candidiasis becomes chronic in 5-8 % of cases [2,3]. Gastrointestinal tract as a reservoir for re-infection, re-infection from sexual partner(s), and recurrent disease as a result of persistent colonization have been postulated. This last postulate is supported by studies showing recurrent disease to be caused by identical strains in the vast majority of cases [2]. Though C. albicans is the main pathogen in more than 95% of cases of acute infection [4], other species are implicated in chronic infection, C. glabrata. A diagnosis of “harmless commensal” is both inappropriate and scientifically inaccurate. Though low-virulence, they are not apathogenic—unlike Saccharomyces cerevisiae
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
