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 (greater-than-or-equal-to 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.