关键词: 复发性外阴阴道念珠菌病, 真菌培养, 药敏, 两性霉素B, 氟康唑

Abstract:

Objective To explore the suitable treatment for patients with RVVC.Methods Forty-five cases of RVVC patients were examined by vaginal discharge drop method and fungal culture method.According to drug sensitivity results,oral fluconazole (use itraconazole if resistant to fluconazole) combined vaginal administration of amphotericin B vaginal medication intensive treatment 3 months,and then clotrimazole vaginal tablets consolidation treatment for 6 months.After stopping the medication regularly follow-up for a year.Record the patient's chief complaint,and take their vaginal secretions to examined by vaginal discharge drop method and fungal culture method to determine whether the presence of Candida.Results Among the 45 patients,vaginal secretions were found in 39 cases (86.67%) of Candida albicans,4 cases (8.89%) of smooth Candida,1 case (2.22%) of Candida glabrata,1 case of Candida tropicalis (2.22%).The resistant rates of Candida to itraconazole,fluconazole,voriconazole,5-fluorocytosine and amphotericin B were 28.89%,22.22%,17.78%,8.89% and 0.00%,respectively.Follow-up 1 year in 4 cases of recurrence,the effective rate of 91.11%,the rate of 8.89%.Conclusion The main pathogen of RVVC is Candida albicans.Candida is highly sensitive to amphotericin B and has low resistance.Fluconazole or itraconazole oral combination of amphotericin B vaginal topical treatment for intensive treatment,plus clotrimazole vaginal tablets for consolidation therapy,had a higher efficient of RVVC treatment.

Key words: recurrent vulvovaginal candidiasis, fungal culture, drug susceptibility, amphotericin B, fluconazole