Analysis of influencing factors for treatment failure of clotrimazole suppositories in patients with first-diagnosed vulvovaginal candidiasis
LI Haihong
WANG Ping
WANG Donghua
Abstract：Objective To analyze the treatment failure status and influencing factors of clotrimazole suppositories in patients with first-diagnosed vulvovaginal candidiasis(VVC).Method This prospective study included 183 patients with first-diagnosed VVC treated in Wuhan No.1 Hospital between January 2023 and January 2025.All received single-agent clotrimazole suppositories for 1 week and were classified into effective treatment and treatment failure groups based on clin-ical response.Demographic characteristics,disease severity,treatment-related factors,and pretreatment laboratory pa-rameters were compared between groups.Independent risk factors for treatment failure were identified via logistic regres-sion analysis.Receiver operating characteristic(ROC)curve and area under the curve(AUC)were used to evaluate the predictive efficacy of combined factors.Result Among 179 patients completing treatment and follow-up(median age 31(29,33)years),19(10.6%)experienced treatment failure.Univariate and multivariate logistic regression analyses iden-tified severe disease,complex infection,poor medication adherence,higher pretreatment vaginal pH,and elevated estro-gen level as independent risk factors for treatment failure,while higher pretreatment serum IgG level was protective factor(all P<0.05).The ROC curve for the predictive model incorporating these six factors showed an AUC of 0.880(95%CI:0.793-0.967).Conclusion Disease severity,infection type,medication adherence,vaginal pH,IgG,and estrogen levels are independently associated with clotrimazole treatment failure in first-diagnosed VVC patients.
Keywords：vulvovaginal candidiasisclotrimazole suppositoriestreatment ineffectivenessinfluencing factors
Publication Date：2025-10-28
Online Publishing Date：2025-11-19(First online date of this platform, not the publication date of the document)
Pages：7( 498-504 )