At day 30 to day 35 of follow-up, mycological cure rates, based on a positive or negative Candida culture, were 94%, 33%, 56% and 40%, respectively.
"Nystatin vaginal suppository could be a therapy choice for vulvovaginal candidiasis caused by Candida glabrata," Dr. Shangrong Fan said.
While C. albicans is the most commonly isolated species, various studies have reported a shift towards infections caused by non-albicans Candida species such as C. glabrata.
The women were enrolled prospectively in separate, sequential, nonrandomized clinical trials and treated with nystatin vaginal suppository at 20 MU per day for 7 days or two 1,200 mg doses of miconazole vaginal suppositories 72 hours apart or oral fluconazole two 150 mg doses 72 hours apart or oral itraconazole 200 mg two times for 1 day.
Dr. Fan, an obstetrician/gynecologist and his colleagues in the department of laboratory sciences at Peking University Shenzhen Hospital in Shenzhen, China, also conducted an in vitro susceptibility study. All strains were identified using the API Candida System and susceptibility testing performed using a commercial (Rosco Diagnostica) agar diffusion method.
The in vitro susceptible rate of C. glabrata on nystatin was 100% (57/57), compared with 90% (51/57) for miconazole, 58% (40/69) for fluconazole, and 87% (58/67) for itraconazole.
The susceptible-dose-dependent rates were 0%, 11%, 39%, and 12%, respectively.
Resistance to nystatin or miconazole was not observed, and occurred in 3% of strains exposed to fluconazole and 1.5% exposed to itraconazole, Dr. Fan said.
Dr. Sobel, Dr. Fan, and their colleagues reported no relevant financial disclosures.