Three-Dose Antifungal Treatment Improves the Efficacy for Severe Vulvovaginal Candidiasis.

IF 3.6 3区 生物学 Q2 MYCOLOGY
Zhansong Xiao, Yiheng Liang, Xiaowei Zhang, Yuxia Zhu, Liting Huang, Shangrong Fan
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Abstract

Vulvovaginal candidiasis (VVC) is a prevalent gynecological infection characterized by high incidence and recurrent episodes, causing significant distress in women. This study aims to assess the effectiveness of different clotrimazole and fluconazole treatment regimens for severe vulvovaginal candidiasis (SVVC). A retrospective analysis was conducted on 1303 cases of SVVC among first-time visitors to the gynecology outpatient department at Peking University Shenzhen Hospital between January 2013 and December 2022. Vaginal secretions were systematically collected for fungal culture, with species identification conducted using Chromogenic culture medium and API Candida test reagents. Mycological cure rates were assessed at days 7-14, days 25-35, and day 35 to 6 months after treatment. The three-dose clotrimazole regimen demonstrated significantly higher mycological cure rates (85.7%, 80.0% and 74.6% at three follow-up periods, respectively) compared to the two-dose clotrimazole regimen (76.0%, 61.6%, and 59.8%, all P < 0.05). The three-dose fluconazole regimen showed no significant difference to three-dose clotrimazole regimen, with cure rates of 82.8%, 79.3%, and 75.9% (all P > 0.05). The two-dose fluconazole regimen had cure rates of 74.3%, 56.4% and 51.1%, with no significant difference from two-dose clotrimazole regimen at days 7-14 and 25-35, but lower than three-dose fluconazole regimen at days 25-35 and 35 to 6 months. The three-dose clotrimazole regimen demonstrated higher cure rates in Candida albicans and non-albicans Candida SVVC cases than two-dose regimen. These findings suggest that three-dose antifungal regimens may be more efficacious than two-dose regimens for SVVC. The three-dose clotrimazole regimen could serve as a promising alternative for SVVC management.

三剂量抗真菌治疗提高了严重外阴阴道念珠菌病的疗效
外阴阴道念珠菌病(VVC)是一种常见的妇科感染,其特点是发病率高且反复发作,给女性带来极大困扰。本研究旨在评估不同克霉唑和氟康唑治疗方案对重度外阴阴道念珠菌病(SVVC)的疗效。研究对2013年1月至2022年12月期间北京大学深圳医院妇科门诊的1303例SVVC初诊患者进行了回顾性分析。系统收集阴道分泌物进行真菌培养,并使用Chromogenic培养基和API念珠菌检测试剂进行菌种鉴定。在治疗后第 7-14 天、第 25-35 天、第 35 天至 6 个月评估真菌学治愈率。与两剂克霉唑疗法(76.0%、61.6% 和 59.8%,均为 P0.05)相比,三剂克霉唑疗法的霉菌学治愈率明显更高(三个随访期的治愈率分别为 85.7%、80.0% 和 74.6%)。两剂氟康唑治疗方案的治愈率分别为 74.3%、56.4% 和 51.1%,在第 7-14 天和第 25-35 天与两剂克霉唑治疗方案无显著差异,但在第 25-35 天和 35 至 6 个月的治愈率低于三剂氟康唑治疗方案。与两剂方案相比,三剂克霉唑方案对白念珠菌和非白念珠菌 SVVC 病例的治愈率更高。这些研究结果表明,三剂抗真菌疗法对 SVVC 的疗效可能优于两剂疗法。三剂克霉唑方案可作为治疗 SVVC 的一种有前途的替代方案。
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来源期刊
Mycopathologia
Mycopathologia 生物-真菌学
CiteScore
6.80
自引率
3.60%
发文量
76
审稿时长
3 months
期刊介绍: Mycopathologia is an official journal of the International Union of Microbiological Societies (IUMS). Mycopathologia was founded in 1938 with the mission to ‘diffuse the understanding of fungal diseases in man and animals among mycologists’. Many of the milestones discoveries in the field of medical mycology have been communicated through the pages of this journal. Mycopathologia covers a diverse, interdisciplinary range of topics that is unique in breadth and depth. The journal publishes peer-reviewed, original articles highlighting important developments concerning medically important fungi and fungal diseases. The journal highlights important developments in fungal systematics and taxonomy, laboratory diagnosis of fungal infections, antifungal drugs, clinical presentation and treatment, and epidemiology of fungal diseases globally. Timely opinion articles, mini-reviews, and other communications are usually invited at the discretion of the editorial board. Unique case reports highlighting unprecedented progress in the diagnosis and treatment of fungal infections, are published in every issue of the journal. MycopathologiaIMAGE is another regular feature for a brief clinical report of potential interest to a mixed audience of physicians and laboratory scientists. MycopathologiaGENOME is designed for the rapid publication of new genomes of human and animal pathogenic fungi using a checklist-based, standardized format.
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