Efficacy of Antifungal Medicines Against Clinical Isolates of Candida Species Responsible for Vaginal Candidiasis from Regional Referral Hospitals in Tanzania

Vaginal candidiasis, caused by <i>Candida species</i> affects a significant proportion of women worldwide. Although different antifungal medicines are being used to treat the infection, the emergence of resistance against these medicines have been reported. This study assessed the efficacy of antifungal medicines which are recommended for treatment in the Tanzania Standard Treatment Guidelines against clinical isolates of <i>Candida spp</i>. Presumptive Isolates of <i>Candida spp.</i> collected from Regional Referral Hospitals (RRH) were transported to the Tanzania Medicine and Medical Devices Authority (TMDA) Microbiology laboratory for identification and confirmation by PCR. The confirmed isolates were used for susceptibility testing to establish the efficacy of antifungal medicines. Results indicate that <i>Candida albicans (54%) </i>was the most prevalent <i>Candida spp.</i> among isolates collected. Among the antifungal medicines tested, Miconazole showed the highest efficacy against 229 isolates of <i>Candida spp.</i> with 89.2% of the isolates being susceptible. This was followed by Clotrimazole, with 79.9% and Nystatin, 79.5% of isolates were susceptible, while Voriconazole showed moderate efficacy with 68.9%. Fluconazole demonstrated the lowest efficacy among the tested antifungals with 63.3%. Both <i>Candida albicans</i> and non-albicans<i> Candida</i> <i>spp.</i> displayed similar susceptibility patterns. Out of the 229 <i>Candida</i> <i>spp</i>. isolates tested, 4.4% were found to exhibit multidrug resistance. Findings from this study suggest that despite the observed resistance, the majority of antifungal medicines listed in the Standard Treatment Guidelines in Tanzania remain effective and are still considered reliable for treating vaginal candidiasis.