Sobel Jack D
Division of Infectious Diseases, Wayne State University School of Medicine, Detroit, MI, USA.
Expert Opin Pharmacother. 2002 Aug;3(8):1059-65. doi: 10.1517/14656566.3.8.1059.
Candida vaginitis is most commonly caused by Candida albicans (> 85%) with little evidence of an increase in vaginitis due to non-C. albicans species. Epidemiological studies are no longer possible in the US in the era of self-diagnosis and -treatment by women empowered by the availability of over-the-counter antimycotics. A new classification of vulvovaginal candidiasis into uncomplicated and complicated vaginitis has simplified choice and duration of antifungal therapy. Vaginitis due to C. albicans responds well to available therapy. In contrast, vaginitis due to Candida glabrata is associated with a high treatment failure rate. Candida vaginitis infection rates in HIV-positive women remain undetermined and reports of refractory fungal vaginitis have not been substantiated. In spite of the wide array of antifungal agents currently available, considerable limitations in available therapy exist in the effective management of complicated vaginitis.
念珠菌性阴道炎最常见由白色念珠菌引起（>85%），几乎没有证据表明非白色念珠菌属导致的阴道炎有所增加。在美国，在女性可自行通过非处方抗真菌药进行自我诊断和治疗的时代，流行病学研究已不再可行。将外阴阴道念珠菌病重新分类为单纯性和复杂性阴道炎，简化了抗真菌治疗的选择和疗程。白色念珠菌引起的阴道炎对现有治疗反应良好。相比之下，光滑念珠菌引起的阴道炎治疗失败率很高。HIV阳性女性的念珠菌性阴道炎感染率仍未确定，难治性真菌性阴道炎的报告也未得到证实。尽管目前有大量抗真菌药物，但在复杂性阴道炎的有效管理方面，现有治疗仍存在相当大的局限性。
