摘要
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.关键词
外阴阴道假丝酵母菌病/克霉唑栓/治疗失败/影响因素Key words
vulvovaginal candidiasis/clotrimazole suppositories/treatment ineffectiveness/influencing factors
