{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:35:29Z","timestamp":1787009729123,"version":"build-2736575974"},"reference-count":18,"publisher":"SAGE Publications","issue":"13","license":[{"start":{"date-parts":[[2022,10,10]],"date-time":"2022-10-10T00:00:00Z","timestamp":1665360000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J STD AIDS"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>We describe 11 cases of refractory vulvovaginal yeast infections (RVVYI) treated using oral voriconazole with or without concomitant topical agents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective case-note review of all women prescribed oral voriconazole to treat RVVYI in five Sexual Health Clinics from Jan 2010-March 2020. Demographic details, clinical features, diagnostic results and treatment outcomes were collected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>11 women with vulvovaginal symptoms for a median of 1\u00a0year were treated with voriconazole. RVVYI was diagnosed clinically and confirmed on microscopy and culture with speciation. 10\/11 isolates were fluconazole resistant, 1 intermediately sensitive, 10\/11 were either fully or intermediately sensitive to voriconazole. All had received prior fluconazole and clotrimazole and 10\/11 had used at least 2-weeks of one or more second-line antifungals with non-clearance of the yeast. Oral voriconazole 400\u00a0mg BD day-1, then 200\u00a0mg BD 13-days was prescribed and 10\/11 women completed the course. Concomitant topical treatment was used by 6\/11. Liver and renal function were monitored at 0, 7, 14\u00a0days. One woman stopped voriconazole after 5-days due to perioral tingling. Other transient side-effects were nausea ( n = 2), photosensitivity, muscle aches, hair thinning (all n = 1), peripheral visual disturbance ( n = 2). 8\/11 experienced both symptom reduction and yeast clearance. Two women had an initial partial response but experienced resolution of symptoms following a second course of voriconazole.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our observational data adds to the limited evidence to support voriconazole treatment for RVVYI. A 2-week course of voriconazole was tolerated and completed by 10\/11 women. Eight women, five using concomitant topical agents, achieved mycological cure.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/09564624221127356","type":"journal-article","created":{"date-parts":[[2022,10,10]],"date-time":"2022-10-10T09:42:54Z","timestamp":1665394974000},"page":"1134-1141","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":9,"title":["Outcomes and experiences of using oral voriconazole with or without concomitant topical agents to treat refractory vulvovaginal yeast infections"],"prefix":"10.1177","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5986-0695","authenticated-orcid":false,"given":"Georgina Claire","family":"Morris","sequence":"first","affiliation":[{"name":"Wiltshire Sexual Health Service, Salisbury NHS Foundation Trust, Salisbury, Wiltshire, United Kingdom of Great Britain and Northern Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gillian","family":"Dean","sequence":"additional","affiliation":[{"name":"Claude Nicol Centre, University Hospitals Sussex NHS Foundation Trust, Brighton, United Kingdom of Great Britain and Northern Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suneeta","family":"Soni","sequence":"additional","affiliation":[{"name":"Claude Nicol Centre, University Hospitals Sussex NHS Foundation Trust, Brighton, United Kingdom of Great Britain and Northern Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sangeetha","family":"Sundaram","sequence":"additional","affiliation":[{"name":"Southampton Sexual Health Services, Solent NHS Trust, Southampton, United Kingdom of Great Britain and Northern Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Fearnley","sequence":"additional","affiliation":[{"name":"Locala Sexual Health, Bradford, United Kingdom of Great Britain and Northern Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet Diane","family":"Wilson","sequence":"additional","affiliation":[{"name":"Leeds Sexual Health, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom of Great Britain and Northern Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,10,10]]},"reference":[{"key":"bibr1-09564624221127356","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)60917-9"},{"key":"bibr2-09564624221127356","doi-asserted-by":"publisher","DOI":"10.1136\/sti.2009.040386"},{"key":"bibr3-09564624221127356","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2012-050669"},{"key":"bibr4-09564624221127356","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2016.02173"},{"key":"bibr5-09564624221127356","doi-asserted-by":"publisher","DOI":"10.1177\/0956462420943034"},{"key":"bibr6-09564624221127356","doi-asserted-by":"publisher","DOI":"10.1586\/ehm.09.1"},{"key":"bibr7-09564624221127356","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkx446"},{"key":"bibr8-09564624221127356","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-017-2913-8"},{"key":"bibr9-09564624221127356","volume-title":"British National Formulary","author":"Joint Formulary Committee"},{"key":"bibr10-09564624221127356","volume-title":"Approved standard. CLSI standard M27","author":"Clinical and Laboratory Standards Institute","year":"2017","edition":"4"},{"key":"bibr11-09564624221127356","volume-title":"Performance standards for antifungal susceptibility testing of yeasts","author":"Clinical Laboratory Standards Institute","year":"2020","edition":"2"},{"key":"bibr12-09564624221127356","doi-asserted-by":"publisher","DOI":"10.1136\/sti.71.5.304"},{"key":"bibr13-09564624221127356","doi-asserted-by":"publisher","DOI":"10.1186\/2047-783x-16-4-139"},{"key":"bibr14-09564624221127356","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.05025-11"},{"key":"bibr15-09564624221127356","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00046-13"},{"key":"bibr16-09564624221127356","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciab841"},{"key":"bibr17-09564624221127356","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2018.03.001"},{"key":"bibr18-09564624221127356","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa1204"}],"container-title":["International Journal of STD &amp; AIDS"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/09564624221127356","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/09564624221127356","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/09564624221127356","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T22:43:50Z","timestamp":1777675430000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/09564624221127356"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,10]]},"references-count":18,"journal-issue":{"issue":"13","published-print":{"date-parts":[[2022,11]]}},"alternative-id":["10.1177\/09564624221127356"],"URL":"https:\/\/doi.org\/10.1177\/09564624221127356","relation":{},"ISSN":["0956-4624","1758-1052"],"issn-type":[{"value":"0956-4624","type":"print"},{"value":"1758-1052","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,10]]}}}