In vitro susceptibility of vaginal Candida isolated from pregnant women to clotrimazole,miconazole and nystatin

Objective To study in vitro susceptibility of Candida isolated from pregnant women to clotrimazole,miconazole and nystatin to provide scientific evidence for the treatment of vulvovaginal candidiasis(VVC)during pregnancy.Methods A total of 121 strains of Candida were isolated from 628 pregnant women.Their susceptibility to anti-fungal drugs(clotrimazole,miconazole and nystatin)was tested in vitro by micro-plate method according to the National Committee for Clinical Laboratory Standards (NCCLS)M27-A Guidelines(M27-A Protocol).Results Prevalence of VVC in pregnant women was 19.3%,with variety of Candida strains,most with Candida albicans.Minimal inhibitory concentration (MIC)of miconazole for Candida albicans at 24 hours was significantly lower than that of nystatin(P 0.01).No significant difference in MIC among these three kinds of antifungal drugs(clotrimazole, miconazole and nystatin)for Candida albicans isolated from varied trimesters of pregnancy was found (P0.05).MICs of miconazole for 32 strains of Candida species other than Candida albicans at 24 and 48 hours were significantly lower than those of nystatin and clotrimazole(P0.01).MICs of clotrimazole and nystatin isolated during the third trimester at 24 and 48 hours were significantly lower than those isolated during the other two trimesters(P0.05).Conclusions Candida albicans isolated from pregnant women were relatively susceptible to antifungal agents.Principles of treatment for VVC caused by Candida albicans during varied trimesters were more or less the same.Cure for VVC caused by Candida species other than Candida albicans was not so easy and usual clotrimazole preparation should not be used.During the first and second trimesters,nystatin preparation could be chosen,but during the third trimester,miconazole could be the choice.