title: Exploratory study on the clinical and mycological effectiveness of a herbal medicinal product from Solanum chrysotrichum in patients with Candida yeast-associated vaginal infection.
abstract: Mexican traditional medicine uses Solanum chrysotrichum to treat fungi-associated dermal and mucosal illness; its methanolic extract is active against dermatophytes and yeasts. Different spirostanic saponins (SC-2-SC-6) were identified as the active molecules; SC-2 was the most active in demonstrating a fungicidal effect against Candida albicans and non-albicans strains. The aim of the present study was to compare the clinical (elimination of signs and symptoms) and mycological effectiveness (negative mycological studies) of an S. chrysotrichum herbal medicinal product (Sc-hmp), standardized in 1.89 mg of SC-2, against ketoconazole (400 mg) in the topical treatment of cervical and/or vaginal infection by Candida. Both treatments (vaginal suppositories) were administered daily during 7 continuous nights. The study included 101 women (49 in the experimental group) with a confirmed clinical condition and positive mycological studies (direct examination and/or culture) of Candida infection. Basal conditions did not show differences between the groups; a moderate clinical picture was present in 62% of the cases, direct examination was positive in 69%, and the culture was positive with C. albicans predominating (65%). At the end of the administration period, both treatments demonstrated 100% tolerability, and clinical cure in 57.14% of S. chrysotrichum-treated cases and in 72.5% of ketoconazole-treated cases (p = 0.16), as well as 62.8% and 97.5% of mycological effectiveness, respectively (p = 0.0 001). We conclude that, at the doses used, Sc-hmp exhibits the same clinical effectiveness as ketoconazole, but with lower percentages of mycological eradication. Additional clinical studies with Sc-hmp are necessary, with increasing doses of SC-2, for improving the clinical and mycological effectiveness.
authors.affiliation: Centro de Investigación Biomédica del Sur, Instituto Mexicano del Seguro Social, Xochitepec, Morelos, Mexico. armandoha_mx@yahoo.com.mx
authors.forename: Armando
authors.initials: A
authors.lastname: Herrera-Arellano
authors.forename: Enrique
authors.initials: E
authors.lastname: Jiménez-Ferrer
authors.forename: Alejandro
authors.initials: A
authors.lastname: Zamilpa
authors.forename: María de los Angeles
authors.initials: Mde L
authors.lastname: Martínez-Rivera
authors.forename: Aída Verónica
authors.initials: AV
authors.lastname: Rodríguez-Tovar
authors.forename: Sara
authors.initials: S
authors.lastname: Herrera-Alvarez
authors.forename: María Luisa
authors.initials: ML
authors.lastname: Salas-Andonaegui
authors.forename: María Yemina
authors.initials: MY
authors.lastname: Nava-Xalpa
authors.forename: Ansberto
authors.initials: A
authors.lastname: Méndez-Salas
authors.forename: Jaime
authors.initials: J
authors.lastname: Tortoriello
mesh_terms: D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000935:Antifungal Agents / Q000302:isolation & purification / Q000494:pharmacology / Q000627:therapeutic use*; D002175:Candida / Q000187:drug effects*; D002176:Candida albicans / Q000187:drug effects*; D002181:Candidiasis, Vulvovaginal / Q000188:drug therapy*; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007654:Ketoconazole / Q000627:therapeutic use; D008875:Middle Aged; D008517:Phytotherapy; D010936:Plant Extracts / Q000494:pharmacology / Q000627:therapeutic use*; D012503:Saponins / Q000302:isolation & purification / Q000494:pharmacology / Q000627:therapeutic use; D032322:Solanum / Q000737:chemistry*; D013488:Suppositories; D055815:Young Adult
chemical_list: D000935:Antifungal Agents; D010936:Plant Extracts; D012503:Saponins; D013488:Suppositories; D007654:Ketoconazole