Treatment of vaginitis caused by Candida glabrata: use of topical boric acid and flucytosine

Am J Obstet Gynecol. 2003 Nov;189(5):1297-300. doi: 10.1067/s0002-9378(03)00726-9.


Objective: The purpose of this study was to review the treatment outcome and safety of topical therapy with boric acid and flucytosine in women with Candida glabrata vaginitis.

Study design: This was a retrospective review of case records of 141 women with positive vaginal cultures of C glabrata at two sites, Wayne State University School of Medicine and Ben Gurion University.

Results: The boric acid regimen, 600 mg daily for 2 to 3 weeks, achieved clinical and mycologic success in 47 of 73 symptomatic women (64%) in Detroit and 27 of 38 symptomatic women (71%) in Beer Sheba. No advantage was observed in extending therapy for 14 to 21 days. Topical flucytosine cream administered nightly for 14 days was associated with a successful outcome in 27 of 30 of women (90%) whose condition had failed to respond to boric acid and azole therapy. Local side effects were uncommon with both regimens.

Conclusions: Topical boric acid and flucytosine are useful additions to therapy for women with azole-refractory C glabrata vaginitis.

MeSH terms

  • Administration, Topical
  • Adolescent
  • Adult
  • Aged
  • Antifungal Agents / administration & dosage*
  • Boric Acids / administration & dosage*
  • Candida glabrata*
  • Candidiasis, Vulvovaginal*
  • Female
  • Flucytosine / administration & dosage*
  • Humans
  • Middle Aged
  • Ointments
  • Retreatment
  • Retrospective Studies
  • Vaginitis / microbiology*


  • Antifungal Agents
  • Boric Acids
  • Ointments
  • Flucytosine
  • boric acid