Treatment
A major phenotype and potential virulence factor that C. glabrata possesses is low-level intrinsic resistance to the azole drugs, which are the most commonly prescribed antifungal (antimycotic) drugs. These drugs, including fluconazole and ketoconazole, are "not effective in 15-20% of cases" against C. glabrata. While some have said that the organism possesses an "innate" immunity to the drugs, it is more accurate to say that the organism possesses an evolved resistance to the drugs. It is still highly vulnerable to polyene drugs such as amphotericin B and nystatin, along with variable vulnerability to flucytosine and caspofungin. However doctors asked about amphotericin B indicate that this is a drug of last resort, in that this drug can often kill the patient while "curing" the fungal infection.
A first-line treatment for vaginal infections may be the use of Terconazole 7-day cream. Several courses may be needed. The cure-rate for this treatment is approximately 40%. Recurrences are common, causing chronic infections and spread to other areas such as skin and scalp. Blood infections might well be best assessed per symptoms if other areas are involved.
An experimental, but effective second-line treatment for chronic infections, is the use of boric acid. Compounding pharmacies can create boric acid vaginal suppositories. Use of Vitamin E oil may be used in conjunction to combat irritation. Amphotericin B vaginal suppositories have also been used in case studies to treat chronic infections, both symptomatic and asymptomatic. Borax and boric acid may be used for persistent scalp and skin infections. Very little information is available regarding treatment for Tortulosis glabrata.
Read more about this topic: Candida Glabrata
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