Re: Boric acid & Abstracts...

[Guest guest]

<My doctor gave me boric acid suppositories.

Has anyone tried it before? Did you like it?? >

HI Kim....

Yes indeed the Boric acid treatment for yeast hon is well known... and it's especially good if someone might have the rarer strains too. Some claim it stung them but I never had a problem with it.

I'll add some abstracts I have on the Boric acid use that I've sent before, to know that it's a good legitimate treatment and far better in my opinion than the standard antiyeast meds. Hope it helps hon.

Dee~

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Abstracts I've collected (5) on Boric Acid & candida (yeast infections) and a letter I added w. suggested usage.

1. Efficacy of maintenance therapy with topical boric acid in comparison with oral itraconazole in the treatment of recurrent vulvovaginal candidiasis

March 2001 • Volume 184 • Number 4

Abstract

Objective: Our purpose was to examine the efficacy of a topical long-term treatment with boric acid versus an oral long-term treatment (itraconazole) in the cure and prevention of recurrent vulvovaginal candidiasis.

Study Design: A prospective, nonrandomized study of patients affected by recurrent vulvovaginal candidiasis was undertaken. In 3 years we recruited 22 consecutive patients who underwent therapy with itraconazole (group 1) or boric acid (group 2). Women were followed up for 1 year, with clinic and microbiologic controls after 1, 3, 6, and 12 months after the first visit.

Results: During the treatment, the positive culture results (15.1% vs 12.1%) and the signs and symptoms (33.3% vs 24.2%) were similar within the 2 groups, with no significant statistical difference.

With the withdrawal, after 6 months, 'relapses' were common in both of the 2 groups (54.5%).

Conclusions: Boric acid seems to be a valid and promising therapy both in the cure of the vaginal infection and in the prevention of relapses of recurrent vulvovaginal candidiasis, but its efficacy ends with the suspension of the therapy.

(Am J Obstet Gynecol 2001;184:598-602.) =========================================

2. Treatment of vaginitis caused by Candida glabrata: Use of topical boric acid and flucytosine November 2003 • Volume 189 • Number 5

Jack D. Sobel, MD., Walter Chaim, MD., Viji Nagappan, MD., Deborah Leaman, RN, BSN

Abstract

Objective The purpose of this study was to review the treatment outcome and safety of topical therapy with boric acid and flucytosine in women with Candida glabrata vaginitis.Study design This was a retrospective review of case records of 141 women with positive vaginal cultures of C glabrata at two sites, Wayne State University School of Medicine and Ben Gurion University.Results The boric acid regimen, 600 mg daily for 2 to 3 weeks, achieved clinical and mycologic success in 47 of 73 symptomatic women (64%) in Detroit and 27 of 38 symptomatic women (71%) in Beer Sheba. No advantage was observed in extending therapy for 14 to 21 days.

Topical flucytosine cream administered nightly for 14 days was associated with a successful outcome in 27 of 30 of women (90%) whose condition had failed to respond to boric acid and azole therapy. Local side effects were uncommon with both regimens.Conclusions Topical boric acid and flucytosine are useful additions to therapy for women with azole-refractory C glabrata vaginitis.

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3. Chronic fungal vaginitis: The value of cultures

Abstract

OBJECTIVE: Our purpose was to examine the importance of fungal cultures in evaluating patients with symptoms of chronic vaginitis by assessing the relative contribution of various yeast species and by comparing infections caused by Candida albicans with those caused by other species.

STUDY DESIGN: A prospective observational study of patients referred with chronic vaginal symptoms was undertaken. In addition to a standard evaluation of symptoms, cultures for yeast were performed on modified Sabouraud agar plates.

RESULTS: Seventy-seven isolates were obtained from 74 patients. A total of 68% were Candida albicans; 32% were other species. The clinical syndromes caused by non–Candida albicans isolates were indistinguishable from Candida albicans infections. Fluconazole (NOTE* Fluconazole is Diflucan given orally, dee) gave a short-term mycologic cure in all Candida albicans but only 25% of non–Candida albicans cases (p < 0.001).

Also in 'non–Candida albicans' infections, boric acid suppositories achieved the 'best' mycologic cure rate (85%).

CONCLUSION: Because non–Candida albicans species are responsible for a significant number of chronic fungal vaginal infections and are more resistant to therapy with fluconazole, (Diflucan) fungal cultures are a valuable aid in confirming the diagnosis and selecting appropriate therapy. (AM J OBSTET GYNECOL)

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4. Risk factors for recurrent vulvovaginal candidiasis in women receiving maintenance antifungal therapy: Results of a prospective cohort studyMarch 2004 • Volume 190 • Number 3

Divya A. Patel, PhD, Gillespie, PhD, Jack D. Sobel, MD., Debbie Leaman, BSN, Nyirjesy, MD, M. Velma Weitz, MSN, Betsy Foxman, PhD

Abstract

Objective The purpose of this study was to examine risk factors for symptomatic vulvovaginal candidiasis episodes among women with 'recurrent' vulvovaginal candidiasis (defined as + 4 vulvovaginal candidiasis episodes in 1 year) who were receiving ''maintenance'' antifungal therapy.Study design A prospective study of 65 women aged 18 years with recurrent vulvovaginal candidiasis who attended vaginitis clinics in Detroit, Mich, and Philadelphia, Pa.Results The 9-month risk of vulvovaginal candidiasis recurrence was 41.8%. Almost two fifths of the women reported activity limitations because of vulvovaginal candidiasis episodes, most or all of the time.

Younger women and those women with a history of 'bacterial vaginosis' were at ''increased'' risk of vulvovaginal candidiasis episodes. )

Behavioral factors that were associated significantly with 'increasing' vulvovaginal candidiasis recurrence 2- fold included wearing pantyliners or pantyhose and consuming cranberry juice or acidophilus-containing products.

(NOTE* This surprised me BIG TIME, with the acidophilus & cranberry juice, to think it can 'increase' Candida recurrence when women use it to prevent that., (prob. the sugar in the juice and I know the strains of acidophilus in the yogurts etc, are NOT the strains the vagina needs. *Dee T.) Conclusion The use of pantyliners or pantyhose, consumption of cranberry juice or acidophilus-containing products, a history of bacterial vaginosis, and age <40 years were positively associated with a symptomatic vulvovaginal candidiasis episode.

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5. LAST ONE..

Vaginitis and Boric Acid Q: Dr. : I've had a recurring problem with vaginitis caused by Candida albicans. In reading your past issues, I saw where you once suggested using vaginal suppositories of boric acid to get rid of the problem. I found boric acid at the pharmacy, so I decided to discuss this with my doctor since none of the medications seem to help anymore. He told me I must be nuts. Now I'm afraid to try the boric acid. Is it safe? Do you still recommend it? E. B., NY

A: I still recommend boric acid suppositories for vaginal candida infections, and yes, it is safe. Blood serum levels of less than 200 ug/ml of boric acid are considered safe, but since it appears that there is no vaginal absorption of boric acid, toxicity isn't even an issue in this case.

There have been several published reports showing that a 600 mg vaginal suppository provides symptomatic relief in just 24 hours. It usually takes about 10 days of treatment (one 600 mg suppository capsule inserted in the morning and another in the evening) to wipe out the infection. If the problem returns, a repeated course of treatment of two to three days might be needed.

One study compared boric acid suppositories to the common drug nystatin. Boric acid was far superior, with a 92% cure rate compared to a 64% cure rate with nystatin.

(Journal of Acquired Immune Deficiency Syndrome and Human Retrovirology 97;16(3):219-220.) Both the capsules and the boric acid are available at pharmacies.

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From Dr. Hope Haefner, U. of Mich ob/gyne edu. and her formula

Boric acid suppositories (per vagina per day)

''Fill 0 gel capsule halfway (600 mg). For the initial treatment a 600 mg capsule is inserted per vagina daily for 14 days. For long term maintenance, insert into vagina twice weekly.

(Especially useful with the Torulopsis glabrata strain of yeast.)

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Which by the way, T. glabrata is resistant to most typical antifungal meds (Diflucan and the azole types used for the usual Candida strain.)

Although one OTC one that is also good for the rarer strains of yeast (and Candida strain) is called 'Vagistat' a 'one time use' with tioconazole in it)

Also I know these Boric acid capsules can be purchased already made up in many health food type stores but I used to make up my own, it was so easy. Buy the Boric acid (don't let it scare you that they use it for bugs.) ..... believe me it's fine and you can buy the empty capsules usually from a local drugstore and fill them yourself if you want to.

Dee~