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Updated: May 16, 2026
08:48
Bio-energetics Investigation of Candida albicans Using Real-time Extracellular Flux Analysis
Published on: March 19, 2019
Fluconazole-resistant Candida albicans vulvovaginitis
Dror Marchaim1, Leslie Lemanek, Suchitha Bheemreddy
1Division of Infectious Diseases, Detroit Medical Center, Wayne State University School of Medicine, Detroit, Michigan, USA.
Obstetrics and Gynecology
|November 22, 2012
Summary
Fluconazole-resistant Candida albicans vaginitis is an emerging problem, with increased occurrence noted in women with prior antifungal exposure. Management of this refractory condition is challenging, necessitating new treatment strategies.
Area of Science:
- Mycology
- Infectious Diseases
- Pharmacology
Background:
- Recurrent Candida albicans vaginitis has high recurrence rates, with fluconazole often used for suppressive therapy.
- Drug resistance to fluconazole in Candida albicans vaginitis is considered rare, but this study investigates its increasing prevalence.
Purpose of the Study:
- To report the increased occurrence of secondary fluconazole resistance in Candida albicans vaginitis.
- To analyze risk factors associated with fluconazole resistance.
- To describe the management of fluconazole-refractory vaginitis.
Main Methods:
- Retrospective study of patients with fluconazole-resistant Candida albicans vaginitis referred to a specialized clinic (2000-2010).
- Data collection via questionnaires and medical charts, including demographics, comorbidities, antifungal exposure, and treatment outcomes.
- Antifungal susceptibility testing performed using broth microdilution to determine minimum inhibitory concentrations (MICs).
Main Results:
- Twenty-five cases of fluconazole-resistant recurrent Candida albicans vaginitis were identified over 11 years.
- Median fluconazole MIC was 8 micrograms/mL; risk factors for failure included increased fluconazole consumption.
- 16 out of 25 patients received low-dose weekly fluconazole maintenance therapy prior to resistance.
- All patients achieved clinical control, but treatment was difficult and prolonged.
Conclusions:
- Fluconazole-resistant Candida albicans vaginitis, previously rare, is an emerging clinical problem.
- Prior fluconazole consumption was a common factor in patients with resistant infections.
- Effective management of fluconazole-refractory vaginitis is challenging, highlighting the need for novel therapeutic approaches.
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