Lack of in Vitro Resistance of Candida Albicans to Ketoconazole, Itraconazole and Clotrimazole in Women Treated for Recurrent Vaginal Candidiasis

Genitourin Med. 1993 Feb;69(1):44-6. doi: 10.1136/sti.69.1.44.


Objective: To determine whether in vitro resistance of Candida albicans to the imidazoles (ketoconazole, clotrimazole and itraconazole) is associated with recurrence of candida vaginitis.

Design: Candida isolates were collected before, during and after treatment from women with recurrent vaginal candidiasis (> or = 4 episodes/year), randomised into two prospective studies: (1) 56 women treated with ketoconazole 400 mg/daily for 7 days; (2) 44 women randomised to receive itraconazole 200 mg orally, or clotrimazole 200 mg intravaginally, twice weekly for six months.

Setting: Women's Candida Clinic at St. Michael's Hospital, a University of Toronto teaching Hospital, Toronto, Ontario, Canada. MAIN OUTCOME, MEASURES: Isolates of yeasts recovered pre and post treatment were tested for significant changes in 50% inhibitory concentration (IC50). Resistance was defined as a greater than fourfold increase in baseline IC50 of post treatment isolates compared with pretreatment isolates.

Results: Over 250 strains of C albicans were tested and none showed development of resistance to any of the agents.

Conclusion: Recurrence of vaginal candidiasis is not related to the development of drug resistance.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antifungal Agents / pharmacology*
  • Candida albicans / drug effects*
  • Candidiasis, Vulvovaginal / drug therapy
  • Candidiasis, Vulvovaginal / microbiology*
  • Clotrimazole / pharmacology*
  • Drug Resistance
  • Female
  • Humans
  • Itraconazole
  • Ketoconazole / analogs & derivatives*
  • Ketoconazole / pharmacology*
  • Middle Aged
  • Prospective Studies
  • Recurrence


  • Antifungal Agents
  • Itraconazole
  • Clotrimazole
  • Ketoconazole