{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T05:30:20Z","timestamp":1790314220729,"version":"4.1.0"},"reference-count":27,"publisher":"American Society for Microbiology","issue":"3","license":[{"start":{"date-parts":[[2012,3,1]],"date-time":"2012-03-01T00:00:00Z","timestamp":1330560000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2012,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            The treatment of vulvovaginal candidiasis (VVC) due to\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">Candida glabrata<\/jats:named-content>\n            is challenging, with limited therapeutic options. Unexplained disappointing clinical efficacy has been reported with systemic and topical azole antifungal agents in spite of\n            <jats:italic>in vitro<\/jats:italic>\n            susceptibility. Given that the vaginal pH of patients with VVC is unchanged at 4 to 4.5, we studied the effect of pH on the\n            <jats:italic>in vitro<\/jats:italic>\n            activity of 11 antifungal agents against 40\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">C. glabrata<\/jats:named-content>\n            isolates and compared activity against 15 fluconazole-sensitive and 10 reduced-fluconazole-susceptibility\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">C. albicans<\/jats:named-content>\n            strains.\n            <jats:italic>In vitro<\/jats:italic>\n            susceptibility to flucytosine, fluconazole, voriconazole, posaconazole, itraconazole, ketoconazole, clotrimazole, miconazole, ciclopirox olamine, amphotericin B, and caspofungin was determined using the CLSI method for yeast susceptibility testing. Test media were buffered to pHs of 7, 6, 5, and 4. Under conditions of reduced pH,\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">C. glabrata<\/jats:named-content>\n            isolates remained susceptible to caspofungin and flucytosine; however, there was a dramatic increase in the MIC\n            <jats:sub>90<\/jats:sub>\n            for amphotericin B and every azole drug tested. Although susceptible to other azole drugs tested at pH 7,\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">C. albicans<\/jats:named-content>\n            strains with reduced fluconazole susceptibility also demonstrated reduced susceptibility to amphotericin B and all azoles at pH 4. In contrast, fluconazole-sensitive\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">C. albicans<\/jats:named-content>\n            isolates remained susceptible at low pH to azoles, in keeping with clinical observations. In selecting agents for treatment of recurrent\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">C. glabrata<\/jats:named-content>\n            vaginitis, clinicians should recognize the limitations of\n            <jats:italic>in vitro<\/jats:italic>\n            susceptibility testing utilizing pH 7.0.\n          <\/jats:p>","DOI":"10.1128\/aac.05025-11","type":"journal-article","created":{"date-parts":[[2012,1,10]],"date-time":"2012-01-10T05:36:20Z","timestamp":1326173780000},"page":"1403-1406","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":102,"title":["Effect of pH on\n            <i>In Vitro<\/i>\n            Susceptibility of Candida glabrata and Candida albicans to 11 Antifungal Agents and Implications for Clinical Use"],"prefix":"10.1128","volume":"56","author":[{"given":"Claire S.","family":"Danby","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Maine Medical Center, Portland, Maine, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dina","family":"Boikov","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Wayne State University School of Medicine, Detroit, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rina","family":"Rautemaa-Richardson","sequence":"additional","affiliation":[{"name":"Manchester Academic Health Science Center, School of Translational Medicine, University of Manchester and University Hospital of South Manchester, Manchester, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack D.","family":"Sobel","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Wayne State University School of Medicine, Detroit, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_1_2_2","first-page":"1195","article-title":"Vaginitis","volume":"107","author":"American College of Obstetricians and Gynecologists","year":"2006","unstructured":"American College of Obstetricians and Gynecologists. 2006. Vaginitis. ACOG Pract. Bull. No. 72 Obstet. Gynecol. 107:1195.","journal-title":"ACOG Pract. Bull. No. 72 Obstet. Gynecol"},{"key":"e_1_3_1_3_2","unstructured":"American College of Obstetricians and Gynecologists. 2009. Vulvar disorders. ACOG Clinical Updates in Women's Health Care vol. 8 no. 2 p 36. American College of Obstetricians and Gynecologists Washington DC."},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.291.11.1368"},{"key":"e_1_3_1_5_2","volume-title":"CLSI document M27\u2013A3","author":"CLSI","year":"2008","unstructured":"CLSI. 2008. Reference method for broth dilution antifungal susceptibility testing of yeasts; approved standard, third edition. CLSI document M27\u2013A3. CLSI, Wayne, PA."},{"key":"e_1_3_1_6_2","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1080\/1120009X.1993.11755468","article-title":"Pharmacokinetics of ciclopirox olamine after vaginal application to rabbits and patients","volume":"5","author":"Coppi G","year":"1993","unstructured":"CoppiG SilingardiS GirardelloR De AloysioD ManzardoS. 1993. Pharmacokinetics of ciclopirox olamine after vaginal application to rabbits and patients. J. Chemother. 5:302\u2013306.","journal-title":"J. Chemother"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00942-09"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.12.1.80"},{"key":"e_1_3_1_9_2","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1067\/mob.2001.111938","article-title":"Efficacy of maintenance therapy with topical boric acid in comparison with oral itraconazole in the treatment of recurrent vulvovaginal candidiasis","volume":"184","author":"Guaschino S","year":"2001","unstructured":"GuaschinoS. 2001. Efficacy of maintenance therapy with topical boric acid in comparison with oral itraconazole in the treatment of recurrent vulvovaginal candidiasis. Am. J. Obstet. Gynecol. 184:598\u2013602.","journal-title":"Am. J. Obstet. Gynecol"},{"key":"e_1_3_1_10_2","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/j.1461-1244.2004.02380.x","article-title":"Ciclopirox: a broad-spectrum antifungal with antibacterial and anti-inflammatory properties","volume":"43","author":"Gupta AK","year":"2004","unstructured":"GuptaAK PlottT. 2004. Ciclopirox: a broad-spectrum antifungal with antibacterial and anti-inflammatory properties. Int. J. Dermatol. 43(Suppl. 1):3\u20138.","journal-title":"Int. J. Dermatol"},{"key":"e_1_3_1_11_2","first-page":"146","article-title":"The in vitro properties of a new hydroxypyridone antimycotic rilopirox, with special reference to its anti-Candida activity","volume":"52","author":"Harada I","year":"1999","unstructured":"HaradaI MitsuiK UchidaK YamaguchiH. 1999. The in vitro properties of a new hydroxypyridone antimycotic rilopirox, with special reference to its anti-Candida activity. Jpn. J. Antibiot. 52:146\u2013152.","journal-title":"Jpn. J. Antibiot"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1179\/joc.2008.20.4.488"},{"key":"e_1_3_1_13_2","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1016\/j.ajic.2009.12.011","article-title":"Risk factors for fluconazole resistance in patients with Candida glabrata bloodstream infection: potential impact of control group selection on characterizing the association between previous fluconazole use and fluconazole resistance","volume":"38","author":"Lee I","year":"2010","unstructured":"LeeI. 2010. Risk factors for fluconazole resistance in patients with Candida glabrata bloodstream infection: potential impact of control group selection on characterizing the association between previous fluconazole use and fluconazole resistance. Am. J. Infect. Control 38:456\u2013460.","journal-title":"Am. J. Infect. Control"},{"key":"e_1_3_1_14_2","doi-asserted-by":"crossref","first-page":"120.e1-5","DOI":"10.1016\/j.ajog.2010.07.010","article-title":"Contemporary perspectives on vaginal pH and lactobacilli","volume":"204","author":"Linhares IM","year":"2011","unstructured":"LinharesIM SummersPR LarsenB GiraldoPC WitkinSS. 2011 Contemporary perspectives on vaginal pH and lactobacilli. Am. J. Obstet. Gynecol. 204:120.e1-5.","journal-title":"Am. J. Obstet. Gynecol"},{"key":"e_1_3_1_15_2","doi-asserted-by":"crossref","first-page":"1270","DOI":"10.1128\/JCM.02363-09","article-title":"Antifungal susceptibility testing of Candida isolates from the Candida surveillance study","volume":"48","author":"Lyon GM","unstructured":"LyonGM KaratelaS SunayS AdiriY, Candida Surveillance Study Investigators. Antifungal susceptibility testing of Candida isolates from the Candida surveillance study. J. Clin. Microbiol. 48:1270\u20131275.","journal-title":"J. Clin. Microbiol"},{"key":"e_1_3_1_16_2","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1080\/1120009X.1993.11739250","article-title":"Local tolerance of a new ciclopirox olamine vaginal preparation in rats and rabbits","volume":"5","author":"Manzardo S","year":"1993","unstructured":"ManzardoS PinzettaA CoppiG. 1993. Local tolerance of a new ciclopirox olamine vaginal preparation in rats and rabbits. J. Chemother. 5:307\u2013312.","journal-title":"J. Chemother"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.43.6.1383"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.47.6.1805-1817.2003"},{"key":"e_1_3_1_19_2","doi-asserted-by":"crossref","first-page":"2009","DOI":"10.1016\/j.ajog.2005.03.034","article-title":"Treatment of non-albicans Candida vaginitis with amphotericin B vaginal suppositories","volume":"192","author":"Phillips AJ","year":"2005","unstructured":"PhillipsAJ. 2005. Treatment of non-albicans Candida vaginitis with amphotericin B vaginal suppositories. Am. J. Obstet. Gynecol. 192:2009\u20132012.","journal-title":"Am. J. Obstet. Gynecol"},{"key":"e_1_3_1_20_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.39.1.40"},{"key":"e_1_3_1_21_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.43.5.2155-2162.2005"},{"key":"e_1_3_1_22_2","doi-asserted-by":"publisher","DOI":"10.2165\/00128071-200203020-00001"},{"key":"e_1_3_1_23_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00163-06"},{"key":"e_1_3_1_24_2","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1093\/clind\/24.4.649","article-title":"Treatment of Torulopsis glabrata vaginitis: retrospective review of boric acid therapy","volume":"24","author":"Sobel JD","year":"1997","unstructured":"SobelJD ChaimW. 1997. Treatment of Torulopsis glabrata vaginitis: retrospective review of boric acid therapy. Clin. Infect. Dis. 24:649\u2013652.","journal-title":"Clin. Infect. Dis"},{"key":"e_1_3_1_25_2","doi-asserted-by":"crossref","first-page":"1059","DOI":"10.2165\/00003495-200363110-00002","article-title":"Management of patients with recurrent vulvovaginal candidiasis","volume":"63","author":"Sobel JD","year":"2003","unstructured":"SobelJD. 2003. Management of patients with recurrent vulvovaginal candidiasis. Drugs 63:1059\u20131066.","journal-title":"Drugs"},{"key":"e_1_3_1_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)60917-9"},{"key":"e_1_3_1_27_2","doi-asserted-by":"crossref","first-page":"1297","DOI":"10.1067\/S0002-9378(03)00726-9","article-title":"Treatment of vaginitis caused by Candida glabrata: use of topical boric acid and flucytosine","volume":"189","author":"Sobel JD","year":"2003","unstructured":"SobelJD ChaimW NagappanV LeamanD. 2003. Treatment of vaginitis caused by Candida glabrata: use of topical boric acid and flucytosine. Am. J. Obstet. Gynecol. 189:1297.","journal-title":"Am. J. Obstet. Gynecol"},{"key":"e_1_3_1_28_2","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1002\/1098-0997(2000)8:5<240::AID-IDOG1026>3.0.CO;2-4","article-title":"Terconazole cream for non-Candida albicans fungal vaginitis: results of a retrospective analysis","volume":"8","author":"Sood G","year":"2000","unstructured":"SoodG NyirjesyP WeitzMV ChatwaniA. 2000. Terconazole cream for non-Candida albicans fungal vaginitis: results of a retrospective analysis. Infect. Dis. Obstet. Gynecol. 8:240\u2013243.","journal-title":"Infect. Dis. Obstet. Gynecol"}],"updated-by":[{"DOI":"10.1128\/aac.00581-11","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2011,6,17]],"date-time":"2011-06-17T00:00:00Z","timestamp":1308268800000}}],"container-title":["Antimicrobial Agents and Chemotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/AAC.05025-11","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/AAC.05025-11","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,2,21]],"date-time":"2022-02-21T22:12:51Z","timestamp":1645481571000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.asm.org\/doi\/10.1128\/AAC.05025-11"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,3]]},"references-count":27,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2012,3]]}},"alternative-id":["10.1128\/AAC.05025-11"],"URL":"https:\/\/doi.org\/10.1128\/aac.05025-11","relation":{},"ISSN":["0066-4804","1098-6596"],"issn-type":[{"value":"0066-4804","type":"print"},{"value":"1098-6596","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,3]]},"assertion":[{"value":"2011-06-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2011-12-24","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2012-02-14","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}