Watch presentation highlights on resistance trends and challenges

This abridged version of a well-received conference presentation provides an overview of resistance in vulvovaginal candidiasis (VVC): its prevalence, causes, and implications for treatment. Presented by Mark G. Martens, MD, FACOG. You can also download the slide deck to share with your colleagues.

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4 facts about drug resistance in VVC


1. The prevalence of VVC caused by non-albicans Candida has increased greatly-and these species are less susceptible to fluconazole18

Although Candida albicans is still the most common cause, non-albicans species now account for 30% of vaginal yeast infections. Many are resistant to commonly prescribed antifungal agents, making treatment more challenging.

2. Fluconazole resistance often begins in the gut

Oral fluconazole is systemic, and a significant amount of the drug remains in the GI tract. Repeated use reduces the C. albicans population in the gut, allowing resistant non-albicans species to thrive and reach the vagina.4

3. Fluconazole doses have increased dramatically

The number of fluconazole pills prescribed has more than doubled since 2005, and nearly 60% of patients get more than 1 fluconazole tablet initially.5 These dosing trends may be another indicator of growing resistance.

4. Optimal treatment for non-albicans VVC is not yet established; CDC Guidelines suggest a non-fluconazole azole for 7-14 days first-line2

The Guidelines also include recommendations for treating VVC in certain populations, including women who are pregnant, diabetic, or immunocompromised.

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Fluconazole risks in pregnancy: A major study reports that even a single, low dose may increase miscarriage risk significantly. The FDA has issued a related Drug Safety Communication. See more