JAC Advance Access originally published online on June 30, 2009
Journal of Antimicrobial Chemotherapy 2009 64(3):571-573; doi:10.1093/jac/dkp228
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Original research |
Therapeutic efficacy of voriconazole against a fluconazole-resistant Candida albicans isolate in a vaginal model
Departamento de Microbiología, Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México
Received 31 March 2009; returned 13 May 2009; revised 5 June 2009; accepted 8 June 2009
* Corresponding author. Tel: +52-81-83294157; Fax: +52-81-83485477; E-mail: gmglez{at}yahoo.com.mx
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 
10 mg/kg and fluconazole at 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 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.
Keywords: vaginal candidosis , vaginitis , murine model , C. albicans