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[Snowcat]

Hi.  So I’ve finally got the results of my test for the persistent thrush I’ve been taking fluconazole for, and it’s been identified at Candida Krusei which is resistant to fluconazole (that explains a lot!) The lab have suggested that I be treated with nystatin pessaries but apparently they’re not available in the UK!

I can’t speak to my doctor until Thursday so I was wondering if any of you in the UK have had this experience particular type of candida and what was prescribed or what worked for you please.  I’m so itchy and sore which on top of the atrophy is just the last straw! Appreciate any input - thank you ☺️

[sheila99]

Try a search of the forum. I can't remember who it was or how long ago (pos 6 months?) but someone else has had a strain that didn't respond to fluconazole. I think they might have got treatment at a sexual health clinic in the end but I can't remember the details.

[Snowcat]

Hi Sheila.  Thank you.  I’m
Not sure how to do that search.  Nothing came up when I put it in the search bar.

[Banjo1973]

Not sure how to link it....

FYI - I have confirmed with my doctor that I indeed have the dreaded Candida Glabrata.  I am on day 5 of Nystatin which finally gave me some relief on day 4.  Doctor looked up results and said the Nystatin, if completed for the fortnight should get rid of it but she also recommended I get boric acid pessaries and continue on with those for a week afterwards and they are also excellent for Glabrata.  As we learned from our friend Midnight Shadow, Glabrata is a nuisance to get rid of.
She also said to use zinc oxide cream on the outside of the vagina area - basic Sudocrem is good.  Not only is it soothing but it has been shown to inhibit candida formation, even in fluconazole-resistant strains of C. glabrata.

[Banjo1973]

https://www.menopausematters.co.uk/forum/index.php/topic,72501.msg975725.html#msg975725

[Snowcat]

That’s interesting Banjo.  I hope you’ll soon be on the mend.  I don’t know where you are by I’ve been told, despite the lab recommending nystatin pessaries, that they aren’t available anymore in the UK.  The GP has given me econazole which I’ve looked up and it basically says don’t bother! Has anyone tried boric acid pessaries for Candida krusei? I’m at a complete loss now and very sore/itchy … I will try the  gynae dept next week and my urologist is trying to help but it seems ridiculous that if you have C Krusei there is no treatment!!! Just want to cry now and my head hurts from banging it against a brick wall - months of severe vulval atrophy and now this! Any help really appreciated! 

[Minusminnie]

This came up on AI overview when i typed in 'boric acid pessaries candida krusi' into Goggle....

Boric acid pessaries are recommended for vaginal candidiasis caused by Candida krusei (Pichia kudriavzevii), especially if the infection is recurrent or does not respond to standard antifungal medications. C. krusei is innately resistant to some common antifungals like fluconazole, making boric acid an effective alternative treatment due to its broad-spectrum antifungal properties. The CDC suggests a specific dosage and duration, but it is crucial to consult a healthcare provider before starting treatment to ensure it's appropriate for your situation.

Why boric acid is used for C. krusei

    Innate resistance to antifungals
    : Some Candida species, including C. krusei (formerly Nakaseomyces glabrata), are naturally resistant to common antifungal drugs like fluconazole.

Broad antifungal action
: Boric acid has antimicrobial and antifungal properties, making it effective against atypical Candida species that don't respond to standard treatments.
Treatment for recurrent infections
: It is often recommended for chronic or recurrent yeast infections, particularly those caused by non-albicans or azole-resistant strains of yeast.

How it is used .......etc

[Snowcat]

Thank you so much Minusminnie! You’re a star! ⭐️ that’s so helpful - I’ll run it by my consultant because it’ll mean not taking my GP’s advice, which I’m happy to do if he’s on board .. I’m sure he’ll be fine with it as he’s super kind & helpful.