I W Fong1, R M Bannatyne, P Wong. 1. Department of Microbiology, St Michael's Hospital, University of Toronto, Ontario, Canada.
Abstract
OBJECTIVE: To determine whether in vitro resistance of Candida albicans to the imidazoles (ketoconazole, clotrimazole and itraconazole) is associated with recurrence of candida vaginitis. DESIGN: Candida isolates were collected before, during and after treatment from women with recurrent vaginal candidiasis (> or = 4 episodes/year), randomised into two prospective studies: (1) 56 women treated with ketoconazole 400 mg/daily for 7 days; (2) 44 women randomised to receive itraconazole 200 mg orally, or clotrimazole 200 mg intravaginally, twice weekly for six months. SETTING:Women's Candida Clinic at St. Michael's Hospital, a University of Toronto teaching Hospital, Toronto, Ontario, Canada. MAIN OUTCOME, MEASURES: Isolates of yeasts recovered pre and post treatment were tested for significant changes in 50% inhibitory concentration (IC50). Resistance was defined as a greater than fourfold increase in baseline IC50 of post treatment isolates compared with pretreatment isolates. RESULTS: Over 250 strains of C albicans were tested and none showed development of resistance to any of the agents. CONCLUSION:Recurrence of vaginal candidiasis is not related to the development of drug resistance.
RCT Entities:
OBJECTIVE: To determine whether in vitro resistance of Candida albicans to the imidazoles (ketoconazole, clotrimazole and itraconazole) is associated with recurrence of candida vaginitis. DESIGN:Candida isolates were collected before, during and after treatment from women with recurrent vaginal candidiasis (> or = 4 episodes/year), randomised into two prospective studies: (1) 56 women treated with ketoconazole 400 mg/daily for 7 days; (2) 44 women randomised to receive itraconazole 200 mg orally, or clotrimazole 200 mg intravaginally, twice weekly for six months. SETTING:Women's Candida Clinic at St. Michael's Hospital, a University of Toronto teaching Hospital, Toronto, Ontario, Canada. MAIN OUTCOME, MEASURES: Isolates of yeasts recovered pre and post treatment were tested for significant changes in 50% inhibitory concentration (IC50). Resistance was defined as a greater than fourfold increase in baseline IC50 of post treatment isolates compared with pretreatment isolates. RESULTS: Over 250 strains of C albicans were tested and none showed development of resistance to any of the agents. CONCLUSION: Recurrence of vaginal candidiasis is not related to the development of drug resistance.
Authors: J N Galgiani; J Reiser; C Brass; A Espinel-Ingroff; M A Gordon; T M Kerkering Journal: Antimicrob Agents Chemother Date: 1987-09 Impact factor: 5.191