title: Therapeutic efficacy of voriconazole against a fluconazole-resistant Candida albicans isolate in a vaginal model.
abstract: BACKGROUND
  The purpose of this study was to assess the therapeutic efficacy of oral versus intravaginal voriconazole and compare it with fluconazole for the treatment of experimental vaginitis caused by a fluconazole-resistant Candida albicans isolate.
  
  
  METHODS
  Mice were treated with voriconazole at 5, 10 and 20 mg/kg once a day and 20 mg/kg twice a day or with fluconazole at 20 mg/kg once or twice a day orally. Intravaginal treatments were evaluated with voriconazole and fluconazole at 0.5, 1 and 5 mg/kg once a day. All treatment regimens were given on days 1-5 post-challenge. One day 6, the vaginas were swabbed to assess treatment effects.
  
  
  RESULTS
  Mice treated orally with voriconazole at >or=10 mg/kg and fluconazole at >or=20 mg/kg showed significantly reduced fungal counts over controls (P = 0.0002-0.007). Significant differences were found between the groups that received voriconazole at 20 mg/kg once or twice daily and those that received fluconazole at 20 mg/kg once or twice daily, orally (P = 0.010 and 0.001, respectively). Mice treated with voriconazole or fluconazole administered intravaginally at >or=0.5 mg/kg exhibited a reduced fungal burden when compared with the control group (P = 0.0002-0.007). There was no statistically significant difference in fungal burden between topical treatment with doses of 0.5, 1 and 5 mg/kg once daily of voriconazole or fluconazole. Sterilization of vaginas was not observed with voriconazole and fluconazole without taking into consideration the therapeutic modality.
  
  
  CONCLUSIONS
  Voriconazole could emerge as a new alternative for treatment of vaginal candidosis.
authors: Departamento de Microbiología, Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México. gmglez@yahoo.com.mx
authors: Gloria M
authors: GM
authors: González
authors: Omar J
authors: OJ
authors: Portillo
authors: Grecia I
authors: GI
authors: Uscanga
authors: Samantha E
authors: SE
authors: Andrade
authors: Miguel
authors: M
authors: Robledo
authors: Candelario
authors: C
authors: Rodríguez
authors: Mariana
authors: M
authors: Elizondo
mesh_terms: D000282:Administration, Intravaginal; D000284:Administration, Oral; D000818:Animals; D000935:Antifungal Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002176:Candida albicans / Q000187:drug effects*; D002177:Candidiasis / Q000188:drug therapy*; D015169:Colony Count, Microbial; D025141:Drug Resistance, Fungal; D005260:Female; D015725:Fluconazole / Q000008:administration & dosage / Q000627:therapeutic use*; D051379:Mice; D008807:Mice, Inbred BALB C; D011743:Pyrimidines / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome; D014230:Triazoles / Q000008:administration & dosage / Q000627:therapeutic use*; D014621:Vagina / Q000382:microbiology*; D065819:Voriconazole
chemical_list: D000935:Antifungal Agents; D011743:Pyrimidines; D014230:Triazoles; D015725:Fluconazole; D065819:Voriconazole