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.
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.