Combined systemic (fluconazole) and topical (metronidazole + clotrimazole) therapy for a new approach to the treatment and prophylaxis of recurrent candidiasis

Genovese, Carlo; Cianci, Antonio; Corsello, S; Ettore, Giuseppe; Mattana, Paolo; Tempera, G

doi:10.23736/s0026-4784.19.04388-0

Cited by 7 publications

(4 citation statements)

References 21 publications

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“… 43 This leads to potentially missing the opportunity to modify the environment and mycotic biorhythm directly prior to the highest risk period. 44 Future adaptations of the study design could utilize variations of the ICTALA IMP dosage form to assess patient preferences.…”

Section: Discussionmentioning

confidence: 99%

Intravaginal Combination Therapy of Acetic and Lactic Acid in premenopausal women with recurrent vulvovaginal candidiasis: A randomized, double-blind placebo-controlled feasibility trial

Strydom,

Khan,

Walpola

et al. 2023

Womens Health (Lond Engl)

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Background: Recurrent vulvovaginal candidiasis management primarily entails azole therapy used as required or as an extended daily or weekly maintenance therapy for 6 months or more. Unfortunately, relapse within 3–6 months of ceasing maintenance therapy is experienced for more than half the patients, for whom indefinite treatment is required. Objectives: To explore the feasibility of trial design examining a prophylaxis treatment to prevent recurrent vulvovaginal candidiasis symptomatic episodes and reduce adverse effects. Study Design: A double-blinded randomized controlled feasibility trial was conducted in Australia. Women with recurrent vulvovaginal candidiasis were enrolled. Methods: An intravaginal prophylaxis application of lactic acid and acetic acid (Intravaginal Combination Therapy of Acetic and Lactic Acid) was compared with placebo. Primary outcomes comprised recruitment and retention, compliance to study medications and study assessments. Secondary outcomes included the reduction of symptomatic recurrence over the trial period and the acceptability, satisfaction, safety and tolerability of the intervention. The feasibility of quality-of-life measures was also explored. Results: Fifteen participants were enrolled and randomized (active = 9, placebo = 6). Consent rate was 23.4%. Eight participants were lost to follow-up (active = 5, placebo = 3). Forty-seven per cent of participants (n = 7) were 100% compliant with the intervention, six of which completed the trial with good assessment compliance. The blinding process was effective. The study demonstrated a reduction in relapse in both active and placebo groups with only four participants across both groups reporting symptomatic episodes while enrolled. The intervention demonstrated good tolerability. Quality-of-life data showed minimal variance with a high quality-of-life measure. Conclusion: This trial assesses the feasibility of conducting a large-scale study exploring the efficacy of the Intravaginal Combination Therapy of Acetic and Lactic Acid intravaginal intervention and hints on the importance of psychological support through appropriate disease-specific communication and clinical attention. Consideration of the reported recruitment challenges, the inclusion of suitable quality-of-life measures and digital data collection is warranted for adaptation to a fully powered trial.

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Section: Discussionmentioning

confidence: 99%

Intravaginal Combination Therapy of Acetic and Lactic Acid in premenopausal women with recurrent vulvovaginal candidiasis: A randomized, double-blind placebo-controlled feasibility trial

Strydom,

Khan,

Walpola

et al. 2023

Womens Health (Lond Engl)

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“…Candida species are also responsible for healthcare-related infections both in immunocompetent and immunocompromised hosts [57,58]. Although new synthetic drugs are generally active against resistant Candida species, their administration can cause toxicity, interactions with other drugs, and inadequate bioavailability [59][60][61]. Experimental evidence supported the anticandidal activity of different extracts from J. regia, including leaf, bark, and root [62][63][64][65].…”

Section: Discussionmentioning

confidence: 99%

Antimicrobial, Antioxidant, and Cytotoxic Activities of Juglans regia L. Pellicle Extract

et al. 2021

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The difficulty to treat resistant strains-related hospital-acquired infections (HAIs) promoted the study of phytoextracts, known sources of bioactive molecules. Accordingly, in the present study, the pharmacological activities of Juglans regia (L.) pellicle extract (WPE) were investigated. The antiviral effect was tested against Herpes simplex virus type 1 and 2, Poliovirus 1, Adenovirus 2, Echovirus 9, Coxsackievirus B1 through the plaque reduction assay. The antibacterial and antifungal activities were evaluated against medically important strains, by the microdilution method. DPPH and superoxide dismutase (SOD)s-like activity assays were used to determine the antioxidant effect. Besides, the extract was screened for cytotoxicity on Caco-2, MCF-7, and HFF1 cell lines by the 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide (MTT) assay. The total phenolic and flavonoid contents were also evaluated. Interestingly, WPE inhibited Herpes simplex viruses (HSVs) replication, bacterial and fungal growth. WPE showed free radical scavenging capacity and inhibited superoxide anion formation in a dose-dependent manner. These effects could be attributed to the high content of phenols and flavonoids, which were 0.377 ± 0.01 mg GE/g and 0.292 ± 0.08 mg CE/g, respectively. Moreover, WPE was able to reduce Caco-2 cell viability, at both 48 h and 72 h. The promising results encourage further studies aimed to better elucidate the role of WPE in the prevention of human infectious diseases.

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“…In another study, antifungal activity of ginger essential oil against the resistance of Candida albicans to Fluconazole isolated from patients with vaginal candidiasis was investigated. In this study, it was shown that ginger essential oil has an inhibitory effect on all isolated samples of C. albicans [10]. According to the study conducted by Dr. Taghavi et al, the antifungal effect of ginger extract on Candida, Glabra, and Krusoei candida was evaluated.…”

Section: Introductionmentioning

confidence: 88%

Gingerly effervescent tablets: investigating the effect of cytotoxicity on gingival fibroblasts and antimicrobial properties under laboratory conditions

2019

Biointerface Res Appl Chem

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Ginger is a medicinal plant with antioxidant, anti-bacterial, anti-inflammatory and anti-fungal properties. The shape of effervescent tablet is a new form of this product for use as a mouthwash. This study investigated the cytotoxicity and antimicrobial properties of gingerly effervescent tablets under laboratory conditions. In this study, MTT assay was done to evaluate in-vitro gingival fibroblast cytotoxicity during 24, 48 and 72 hours. In addition, the effect of antimicrobial properties on common bacterial and oral fungi was investigated. P- value was considered significantly less than 0.05. There was no significant difference between the mean of live cells in groups with 24, 48 and 72 duration (P-value = 0.071). There was no significant difference between ginger group and control group (P<0.05). Minimum inhibitory concentration (MIC) of effervescent tablet was different, ranging from 10 mg/ml for Candidas family to 20 mg/ml for Staphylococcus and 40 mg/ml for negative grams. According to the results, it can be concluded that gingerly effervescent tablets have no toxic effect after 72 hours of exposureto gingival fibroblasts. Its suitable antimicrobial properties for fungi makes it useful for the control of infection and as an ideal mouthwash.

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Combined systemic (fluconazole) and topical (metronidazole + clotrimazole) therapy for a new approach to the treatment and prophylaxis of recurrent candidiasis

Cited by 7 publications

References 21 publications

Intravaginal Combination Therapy of Acetic and Lactic Acid in premenopausal women with recurrent vulvovaginal candidiasis: A randomized, double-blind placebo-controlled feasibility trial

Intravaginal Combination Therapy of Acetic and Lactic Acid in premenopausal women with recurrent vulvovaginal candidiasis: A randomized, double-blind placebo-controlled feasibility trial

Antimicrobial, Antioxidant, and Cytotoxic Activities of Juglans regia L. Pellicle Extract

Gingerly effervescent tablets: investigating the effect of cytotoxicity on gingival fibroblasts and antimicrobial properties under laboratory conditions

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