Drug resistance for vaginal yeast infection and bacterial vaginosis increased, what is the optimal solution for treating these diseases in Africa?
Drug resistance to antifungal and antibiotic treatments in Africa is a growing concern, particularly for commonly used vaginal suppositories like clotrimazole, metronidazole, and clindamycin. Resistance rates vary by region and population, with metronidazole resistance in bacterial vaginosis being a significant issue, particularly in populations with HIV. In this article we will present an optimal alternative method when the above medications are not effective.
Antifungal Resistance in yeast infections
There are some studies have shown that Candida infections, including vaginal yeast infections, are common in African women. It is estimated that between 20% to 40% of of women in various regions will experience vaginal Candida infections at some point in their lives. Vaginal yeast infections are particularly prevalent among women of reproductive age, with higher rates reported in women who are pregnant, diabetic, or living with HIV/AIDS. With that high rate of infections, and especially accesing to healthcare is limited, women may self-diagnose and self-medicate using antifungal treatments. This overuse and misuse of antifungal medicines lead to high rate of resistance.
The current rate of resistance to azole antifungal drugs is very common due to the drug’s large ability to be absorbed into the blood and the abuse of this drug by patients. Resistance to antifungals occurs through various mechanisms, such as mutations in the target enzyme (e.g., lanosterol 14α-demethylase for azoles), changes in the cell membrane to reduce drug uptake, or increased efflux pumps that expel the drug from fungal cells. Fungi like Candida albicans, Candida glabrata, and Candida krusei are among those exhibiting resistance to common antifungals. In particular, fluconazole resistance has been increasingly reported in Africa. For instance, a study in Nigeria showed that about 10-20% of Candida isolates were resistant to commonly used azoles like fluconazole. Other study shows that the resistance of clotrimazole in Kenya is about 74%. Moreover, other studies have reported cross-resistance to fluconazole in patients receiving itraconazole and other previously administered azole therapies, such as ketoconazole and miconazole. Similar cross-resistance was recently reported in South Africa where 37% of C. parapsilosis isolates were susceptible to fluconazole and voriconazole, and 44% of fluconazole-resistant isolates were voriconazole cross-resistant. The cross-resistant increases the rate of drug like azoles resistance and reduces the options for treating fungal infections.
In addition to azole antifungals, a low-resistance option that is preferred in cases of recurrent and unresponsive vaginitis is Nystatin vaginal suppository. Nystatin works primarily locally in the vaginal area, where it is needed most, and has very low systemic absorption. This means that Nystatin directly targets the infection in the vagina, making it a safer option for those concerned about potential systemic side effects or who may be at higher risk for side effects from oral antifungals such as pregnant or lactation women.
No systemic resistance risk: Since Nystatin is poorly absorbed into the bloodstream, it doesn’t contribute to the development of systemic antifungal resistance. Resistance to Nystatin is extremely rare, particularly compared to some other antifungal drugs like azoles.
Antibiotic Resistance in woment with Bacterial Vaginosis and Other Infections
Besides antifungal drugs, treatment of vaginitis is also indicated with antibiotics for increase treatment effectivenes, especially in vaginitis superinfection. Currently, there are two commonly used antibiotics: metronidazole and clindamycin. Metronidazole resistance rates can range from 10-20% in some African populations, particularly in regions with high rates of self-medication, overuse of antibiotics, or HIV infection. For instance, studies in South Africa and Kenya have shown that metronidazole resistance among BV-causing organisms is an increasing issue. In addition, a study from Uganda found resistance rates of up to 30% to metronidazole in patients with BV. Clindamycin resistance is generally lower but is still a concern in the treatment of more complex or recurrent infections.
Because of the scarcity of new antibiotics and the high rate of drug resistance, current treatment regimens are gradually moving towards antibacterial agents, currently one of the optimal antibacterial agents for women with vaginitis is dequalinium chloride. Dequalinium chloride is effective against a broad spectrum of microorganisms, including Gram-positive and Gram-negative bacteria, fungi, and protozoa. At a given dose, the activity of dequalinium chloride was higher as compared to the other substances. In view of its wide antimicrobial spectrum dequalinium chloride is an efficient alternative in the local therapy of vaginal infections such as fluor vaginalis, bacterial vaginosis, aerobic vaginitis, vulvo-vaginal candidiasis and trichomoniasis.
Vsuppo Yeast & Bacterial Treat is the first-line or alternative treatment of vaginitis
In the situation that the above treatments are gradually becoming resistant, we offer an optimal formula for first-line or alternative treatment when the traditional therapies are ineffective in vaginal infections caused by fungi and bacteria: Vsuppo Yeast & Bacterial Treat.
Vsuppo contains Nystatin, Dequanilium chloride, vitamin E. As above clude, nystatin is an ingredient that kills and inhibits the growth of fungi in the vaginal environment, especially Candida. Nystatin shows broad activity against many yeast strains, is well tolerated and rarely develops drug resistance. Dequanilium is wide range treatment of is a multi-purpose agent that inhibits and destroys bacteria, fungi and flagellates. Besides, two ingredients is poorly absorbed into blood system, so Vsuppo is very safe options for sensitive women such as prenency and lactation women. Morover, vitamin E is an antioxidant, and it also has the effect of softening the vaginal area, helping to reduce discomfort for the patient.
If you are looking for a complicated and multidrug-resistant vaginitis treatment method, Vsuppo is one of the best choise.
