article · American Journal of Life Sciences
Vaginal candidiasis affects many women globally, but the emergence of antifungal resistance presents a growing challenge. An assessment of antifungal medicines listed in the Tanzania Standard Treatment Guidelines was conducted using clinical isolates collected from Tanzanian Regional Referral Hospitals. After identification and PCR confirmation at the Tanzania Medicine and Medical Devices Authority laboratory, susceptibility testing was performed on 229 confirmed isolates. Candida albicans was the most prevalent species identified, making up 54 percent of the samples. Among the tested medicines, miconazole demonstrated the highest efficacy, with 89.2 percent of isolates showing susceptibility. Clotrimazole and nystatin also exhibited high efficacy at 79.9 percent and 79.5 percent respectively. In contrast, voriconazole achieved 68.9 percent susceptibility, and fluconazole had the lowest efficacy at 63.3 percent. Overall, 4.4 percent of the isolates showed multidrug resistance, yet the majority of standard guideline medicines remain reliable options.
Understanding which antifungal treatments remain potent is vital for managing recurrent and resistant reproductive tract infections. These findings show that common standard treatments like miconazole and clotrimazole still work effectively in the clinic, while highlighting lower susceptibility to fluconazole. This helps medical practitioners and health authorities refine treatment protocols to ensure patients receive effective care.
This research provides clinical susceptibility data that can directly inform national treatment guidelines, public procurement bodies, and pharmaceutical distributors managing antifungal supplies. The work represents applied clinical testing rather than a product development pipeline, meaning it has immediate relevance for treatment policy and procurement decisions rather than early-stage commercialisation.
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Vaginal candidiasis, caused by Candida species affects a significant proportion of women worldwide. Although different antifungal medicines are being used to treat the infection, the emergence of resistance against these medicines have been reported. This study assessed the efficacy of antifungal medicines which are recommended for treatment in the Tanzania Standard Treatment Guidelines against clinical isolates of Candida spp. Presumptive Isolates of Candida spp. collected from Regional Referral Hospitals (RRH) were transported to the Tanzania Medicine and Medical Devices Authority (TMDA) Microbiology laboratory for identification and confirmation by PCR. The confirmed isolates were used for susceptibility testing to establish the efficacy of antifungal medicines. Results indicate that Candida albicans (54%) was the most prevalent Candida spp. among isolates collected. Among the antifungal medicines tested, Miconazole showed the highest efficacy against 229 isolates of Candida spp. with 89.2% of the isolates being susceptible. This was followed by Clotrimazole, with 79.9% and Nystatin, 79.5% of isolates were susceptible, while Voriconazole showed moderate efficacy with 68.9%. Fluconazole demonstrated the lowest efficacy among the tested antifungals with 63.3%. Both Candida albicans and non-albicans Candida spp. displayed similar susceptibility patterns. Out of the 229 Candida spp. isolates tested, 4.4% were found to exhibit multidrug resistance. Findings from this study suggest that despite the observed resistance, the majority of antifungal medicines listed in the Standard Treatment Guidelines in Tanzania remain effective and are still considered reliable for treating vaginal candidiasis.
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DOI: 10.11648/j.ajls.20251306.13
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