Treatment of Torulopsis glabrata vaginitis: Retrospective review of boric acid therapy

The charts of all patients who were seen at a vaginitis clinic between January 1989 and December 1994 were retrospectively reviewed; 80 patients whose vaginal cultures yielded Torulopsis glabrata were identified. Sixty of these patients experienced 75 symptomatic episodes of vaginitis attributed to T. glabrata, and these patients are the subject of this review. Of the 60 symptomatic patients, 40 had uncomplicated T. glabrata infection, and 20 had mixed infection, most commonly in association with bacterial vaginosis. Evaluation of treatment of T. glabrata vaginitis with vaginal boric acid (600 mg/d for 14 days) revealed clinical improvement or cure in 21 (81%) of 26 episodes and mycological eradication in 20 (77%) of 26 episodes. One-third of the patients received maintenance therapy with boric acid. The clinical response and mycological eradication rates associated with therapy with topical and systemic azoles were < 50%. The rate of therapeutic response to boric acid administered to patients with mixed T. glabrata infection remained high. In conclusion, in this series of patients with T. glabrata vaginitis, for whom repeated courses of antimycotic therapy with azoles had previously failed, boric acid emerged as a promising modality of therapy.