Antifungal

Intensive care medicine

Biology

Refractory (planetary science)

Drug resistance

Azole

Vaginitis

Dermatology

Drug

Candida albicans

Microbiology

Pharmacology

Astrobiology

Vulvovaginal Candidiasis

Gynecology

Fluconazole

Medicine

Expert Opinion on Pharmacotherapy

Clinicians are increasingly challenged by patients with refractory vulvovaginal candidiasis (VVC) caused by azole-resistant Candida species. Fluconazole resistant C.albicans is a growing and perplexing problem following years of indiscriminate drug prescription and unnecessary drug exposure and for which there are few therapeutic alternatives. Regrettably, although the azole class of drugs has expanded, new classes of antifungal drugs have not been forthcoming, limiting effective treatment options in patients with azole resistant Candida vaginitis.This review covers published data on epidemiology, pathophysiology and treatment options for women with azole-resistant refractory VVC.Fluconazole resistant C.albicans adds to the challenge of azole resistant non-albicans Candida spp. Both issues follow years of indiscriminate drug prescription and unnecessary fluconazole exposure. Although an understanding of azole resistance in yeast has been established, this knowledge has not translated into useful therapeutic advantage. Treatment options for such women with refractory symptoms are extremely limited. New therapeutic options and strategies are urgently needed to meet this challenge of azole drug resistance.

Current treatment options for vulvovaginal candidiasis caused by azole-resistant Candida species