Therapeutic Efficacy of Voriconazole in Fluconazole Resistant Vaginal Candidiasis

ABSTRACT

Background: Candida species is known as the most commonopportunistic yeast affecting the genitourinary tract. Thetriazoles are commonly used for the treatment of candidiasis.But the increasing resistance of Candida to different azolescreated a demand for newer drugs.Objective: Voriconazole is a second generation azoleantifungal agent that shows excellent in vitro activity against awide variety of yeast and moulds. This study was done toassess the therapeutic efficacy of Voriconazole in Fluconazoleresistant vaginal candidiasis.Material and Methods: This one-group pretest-posttest quasiexperiment was conducted in a specialized private chamber ofFaridpur, Bangladesh from January 2018 to July 2019. Vaginalcandidiasis was diagnosed by clinical features, microscopicexamination, culture and sensitivity of high vaginal swab.Voriconazole was used only in Fluconazole resistant vaginalcandidiasis.Results: During the study period, 568 patients were presentedwith vulvovaginitis. Among them, in 267 (47%) patients,Candida albicans were isolated. All patients were treated byFluconazole as first-line treatment. 160 (60%) of those patientsdid not improve clinically and were treated by Voriconazole.Success rate was 93% (149). Regarding side effects ofVoriconazole, transient visual disturbance occurred in 35% ofthe patients, nausea and vomiting in 20% of the patients.Conclusion: Due to wide species variety of Candida andincreasing resistance, Voriconazole may be the second linetreatment of vaginal candidiasis.