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Whole Genome Sequencing of Candida glabrata for Detection of Markers of Antifungal Drug Resistance
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Fluconazole-Resistant Vulvovaginal Candidosis: An Update on Current Management
Karolina Akinosoglou1,2, Achilleas Livieratos3, Konstantinos Asimos4
1Department of Medicine, University of Patras, 265 04 Rio, Greece.
Pharmaceutics
|January 8, 2025
Summary
Managing fluconazole-resistant vulvovaginal candidiasis (FRVVC) requires exploring alternative antifungals and individualized treatment. Avoiding unnecessary antifungal use and cautious antibiotic prescribing are crucial for effective VVC management.
Area of Science:
- Mycology
- Infectious Diseases
- Pharmacology
Background:
- Rising prevalence of resistant *Candida* species (*Candida albicans*, *Candida glabrata*, *Candida krusei*) poses management challenges.
- Fluconazole-resistant vulvovaginal candidiasis (FRVVC) necessitates alternative therapeutic strategies.
- Antifungal overuse for non-*Candida* infections contributes to resistance and treatment failures.
Purpose of the Study:
- To review current management strategies for fluconazole-resistant vulvovaginal candidiasis (FRVVC).
- To explore alternative antifungal therapies and treatment regimens.
- To emphasize the impact of antibiotic use on microbiota and antifungal resistance.
Main Methods:
- Literature review of studies on FRVVC management.
- Identification of alternative antifungal agents (e.g., boric acid, nystatin, oteseconazole, ibrexafungerp).
- Analysis of treatment regimens, including individualized degressive (ReCiDiF) approaches.
Main Results:
- Alternative therapies show promise for FRVVC.
- Tailored treatment regimens are essential due to regional resistance variability.
- The ReCiDiF regimen offers a personalized approach to minimize dosage and control infection.
- Antibiotic use can disrupt microbiota, increasing VVC risk and promoting fluconazole resistance.
Conclusions:
- Effective FRVVC management requires a shift from high-dose maintenance to individualized, degressive treatment.
- Judicious use of antifungals and antibiotics is critical to combat resistance and preserve microbiota.
- Further research into novel agents and treatment strategies is warranted.
Keywords:
fluconazole-refractory vulvovaginal candidosisfluconazole-resistant vulvovaginal candidosisrecurrent vulvovaginal candidosisMore Related Videos
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