Boric acid suppositories are effective in the treatment of Candida vulvovaginitis caused by Candida glabrata in patients with diabetes mellitus
The most common causative agents of candidiasis vulvovaginitis in diabetic patients are non albicans strains of fungi of the genus Candida, such as C.glabrata and C.tropicalis. Observational studies show that the anti-fungal drugs of the azole group have been shown to be effective in treating candidiasis of vulvovaginitis caused by C.glabrata in patients with diabetes mellitus.
According to a randomized study by Indian scientists led by Ray D., the use of boric acid vaginal suppositories is a more effective treatment for candidiasis vulvovaginitis caused by C.glabrata in diabetic patients versus fluconazole therapy.
The study randomized 112 patients with diabetes mellitus and candidiasis vulvovaginitis: group 1 - a single dose of oral fluconazole at a dose of 150 mg; Group 2 - the use of vaginal suppositories with boric acid (600 mg) for 14 days.
The initial efficacy evaluation was based on the frequency of microbiological efficacy in patients with Candida vulvovaginitis caused by C.glabrata in both groups. Secondary efficacy assessment - based on the frequency of microbiological efficacy in patients with Candida vulvovaginitis caused by C. albicans, general microbiological efficacy, frequency of detection of colonies of yeast-like fungi with direct microscopy and clinical symptoms of candida vulvovaginitis on the 15th day of treatment.
Out of 111 patients, in 68 (61.3%) microbiological studies, C.glabrata was isolated, in 32 (28.8%) - C. albicans.
According to the results of the analysis, according to the prescribed treatment (n = 111), the microbiological efficacy of the treatment was reached in 63.6% of patients in group 2 and 28.6% of patients in group 1 with vulvovaginitis Candida caused by C.glabrata (p = 0.01). Similar results were obtained during analysis according to the protocol (n = 99) (72.4% vs 33.3%). There was no significant difference between groups in the levels of microbiological efficacy in patients with Candida vulvovaginitis caused by C.albicans.
The use of suppositories with boric acid is an effective treatment for the first line of Candida vulvovaginitis caused by both C.albicans and C.glabrata in patients with diabetes mellitus.