Terconazole cream for non-Candida albicans fungal vaginitis: results of a retrospective analysis.
OBJECTIVE
Although it is FDA-approved for use in vulvovaginal candidiasis caused by non-Candida albicans species, terconazole cream has not been been studied in patients with these infections. We sought to assess the clinical and mycological efficacy of terconazole cream in women with non-C. albicans vaginitis.


METHODS
The records of patients who had received a 7-day course of terconazole cream for culture-proved non-C. albicans vaginitis were reviewed. Data with regard to patient demographics, clinical and mycologic response to therapy within 1 month of treatment, and outcome with other antifungal therapies were analyzed.


RESULTS
Twenty-eight patients received terconazole cream for non-C. albicans infections. Three patients did not return for follow-up. The median age was 45 years. Seven (28%) patients were nulliparous. The median duration of symptoms was 3 years. Nine patients (36%) had received terconazole within the 6 months prior to referral. Overall, there were 20 C. glabrata cases, 3 C. parapsilosis, and 2 C. lusitaniae. Fourteen (56%) patients achieved a mycologic cure; 11 (44%) noted a resolution of their symptoms. Prior terconazole use was not associated with treatment failure (P = 0.09). Ten failures received boric acid suppositories as subsequent treatment; a cure was effected in 4 (40%). Two of three patients (67%) were eventually cured with flucytosine cream. Five (20 %) patients remained uncured.


CONCLUSIONS
Terconazole cream may be an appropriate first-line treatment for non C. albicans vaginitis, even in patients who have previously received the drug.
Sood
G
G
Section of Infectious Diseases, Department of Medicine, Temple University School of Medicine, Philadelphia, PA 19140, USA.
Nyirjesy
P
P
Weitz
M V
MV
Chatwani
A
A
D000935:Antifungal Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001888:Boric Acids / Q000008:administration & dosage; D002181:Candidiasis, Vulvovaginal / Q000188:drug therapy*; D005260:Female; D005437:Flucytosine / Q000008:administration & dosage; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014230:Triazoles / Q000494:pharmacology / Q000627:therapeutic use*; D014622:Vaginal Creams, Foams, and Jellies
D000935:Antifungal Agents; D001888:Boric Acids; D014230:Triazoles; D014622:Vaginal Creams, Foams, and Jellies; C037815:terconazole; D005437:Flucytosine