Current treatment options for vulvovaginal candidiasis caused by azole-resistant Candida species
Abstract
INTRODUCTION: Clinicians are increasingly challenged by patients with refractory vulvovaginal candidiasis (VVC) caused by azole-resistant Candida species. Fluconazole resistant C.albicans is a growing and perplexing problem following years of indiscriminate drug prescription and unnecessary drug exposure and for which there are few therapeutic alternatives. Regrettably, although the azole class of drugs has expanded, new classes of antifungal drugs have not been forthcoming, limiting effective treatment options in patients with azole resistant Candida vaginitis. AREAS COVERED: This review covers published data on epidemiology, pathophysiology and treatment options for women with azole-resistant refractory VVC. EXPERT OPINION: Fluconazole resistant C.albicans adds to the challenge of azole resistant non-albicans Candida spp. Both issues follow years of indiscriminate drug prescription and unnecessary fluconazole exposure. Although an understanding of azole resistance in yeast has been established, this knowledge has not translated into useful therapeutic advantage. Treatment options for such women with refractory symptoms are extremely limited. New therapeutic options and strategies are urgently needed to meet this challenge of azole drug resistance.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Recurrence can result from developed resistance to antifungal treatment, usually due to prolonged or repeated use of a single agent.
“Recurrence can also result from developed resistance to antifungal treatment, usually due to prolonged or repeated use of a single agent. 11”
From Clinical challenges in diagnosis and treatment of recurrent vulvovaginal candidiasis (2022) · cites this paper as [11]
Breakthrough infections are still relatively rare (usually <5% of patients).
“Although breakthrough infections are still relatively rare (usually < 5% of patients), in vitro susceptibility testing can be useful in selecting subsequent treatment.11,18”
From Clinical challenges in diagnosis and treatment of recurrent vulvovaginal candidiasis (2022) · cites this paper as [11]
Development of azole-resistant infection may be suspected in women who do not respond to standard treatment regimens or who experience breakthrough symptoms despite compliant long-term fluconazole maintenance therapy.
“Development of azole-resistant infection may be suspected in women who do not respond to standard treatment regimens or who experience breakthrough symptoms despite compliant long-term fluconazole maintenance therapy. 11”
From Clinical challenges in diagnosis and treatment of recurrent vulvovaginal candidiasis (2022) · cites this paper as [11]
Treating azole-resistant vaginitis constitutes a major clinical challenge for providers, given the current paucity of alternative antimycotic agents.
“Treating azole-resistant vaginitis constitutes a major clinical challenge for providers, given the current paucity of alternative antimycotic agents. 11”
From Clinical challenges in diagnosis and treatment of recurrent vulvovaginal candidiasis (2022) · cites this paper as [11]
In vitro susceptibility testing can be useful in selecting subsequent treatment.
“in vitro susceptibility testing can be useful in selecting subsequent treatment.11,18”
From Clinical challenges in diagnosis and treatment of recurrent vulvovaginal candidiasis (2022) · cites this paper as [11]
Non-albicans Candida species are frequently dose-dependent susceptible or resistant to fluconazole and other azoles.
“In addition, non-albicans Candida species are frequently dose-dependent susceptible or resistant to fluconazole and other azoles, and their prevalence is rising.”
From Management of recurrent vulvovaginal candidosis: Narrative review of the literature and European expert panel opinion (2022) · cites this paper as Sobel and Sobel, 2018
A long-term prophylactic maintenance regimen with antifungals is often necessary for RVVC.
“A long-term prophylactic maintenance regimen with antifungals is often necessary.”
From Management of recurrent vulvovaginal candidosis: Narrative review of the literature and European expert panel opinion (2022) · cites this paper as Sobel and Sobel, 2018
Available therapeutic options to treat fluconazole-resistant C. albicans and low susceptibility non-albicans strains are limited.
“Available therapeutic options to treat such fluconazole-resistant C. albicans and low susceptibility non-albicans strains are limited.”
From Management of recurrent vulvovaginal candidosis: Narrative review of the literature and European expert panel opinion (2022) · cites this paper as Sobel and Sobel, 2018
Many fluconazole-resistant C. albicans strains are also cross-resistant to other azole drugs available for treating VVC.
“Many fluconazole-resistant C. albicans strains are also cross-resistant to other azole drugs available for treating VVC.”
From Management of recurrent vulvovaginal candidosis: Narrative review of the literature and European expert panel opinion (2022) · cites this paper as Sobel and Sobel, 2018
Fluconazole-resistant C. albicans vaginitis usually represents less than 5% of isolates obtained from women with RVVC.
“Fluconazole-resistant C. albicans vaginitis usually represents less than 5% of isolates obtained from women with RVVC (Sobel and Sobel, 2018; Collins et al., 2020).”
From Management of recurrent vulvovaginal candidosis: Narrative review of the literature and European expert panel opinion (2022) · cites this paper as Sobel and Sobel, 2018
Treatment with first- or second-generation azoles for C glabrata infection is usually unsuccessful.
“Treatment with first- or second-generation azoles for C glabrata infection is usually unsuccessful, and local nystatin, ciclopiroxolamine, or boric acid is recommended (Sobel and Sobel, 2018).”
From Management of recurrent vulvovaginal candidosis: Narrative review of the literature and European expert panel opinion (2022) · cites this paper as Sobel and Sobel, 2018
Cites
J Antimicrob Chemother 1994; 33: 350–351
O’Shaughnessy, E. M., & DAS, S. S. (1994) · Journal of Antimicrobial Chemotherapy · doi:10.1093/jac/33.2.350 · Cited by 3,746 · see citing works
Pappas, P. G., Kauffman, C. A., Andes, D., Benjamin, D. K., Calandra, T. F., Edwards, J. E., Filler, S. G., Fisher, J. F., Kullberg, B.-J., Zeichner, L. O., et al. (2009) · Clinical Infectious Diseases · doi:10.1086/596757 · Cited by 3,191 · see citing works
Sobel, J. D. (2007) · The Lancet · doi:10.1016/s0140-6736(07)60917-9 · Cited by 1,270 · see citing works
Self-citationResistance of Candida species to fluconazole
Rex, J. H., Rinaldi, M. G., & Pfaller, M. A. (1995) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.39.1.1 · Cited by 879 · see citing works
Multidrug-Resistant Candida: Epidemiology, Molecular Mechanisms, and Treatment
Arendrup, M. C., & Patterson, T. F. (2017) · The Journal of Infectious Diseases · doi:10.1093/infdis/jix131 · Cited by 707 · see citing works
Global burden of recurrent vulvovaginal candidiasis: a systematic review
Denning, D. W., Kneale, M., Sobel, J. D., & Rautemaa-Richardson, R. (2018) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(18)30103-8 · Cited by 639 · see citing works
Self-citationWhite, T. C. (1997) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.41.7.1482 · Cited by 612 · see citing works
Sanglard, D., Ischer, F., Monod, M., & Bille, J. (1997) · Microbiology · doi:10.1099/00221287-143-2-405 · Cited by 587 · see citing works
Recurrent vulvovaginal candidiasis
Sobel, J. D. (2016) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2015.06.067 · Cited by 502 · see citing works
Self-citationMaintenance Fluconazole Therapy for Recurrent Vulvovaginal Candidiasis
Sobel, J. D., Wiesenfeld, H. C., Martens, M., Danna, P., Hooton, T. M., Rompalo, A., Sperling, M., Livengood, C., Horowitz, B., Von Thron, J., et al. (2004) · New England Journal of Medicine · doi:10.1056/nejmoa033114 · Cited by 487 · see citing works
Self-citationHargrove, T. Y., Friggeri, L., Wawrzak, Z., Qi, A., Hoekstra, W. J., Schotzinger, R. J., York, J. D., Guengerich, F. P., & Lepesheva, G. I. (2017) · Journal of Biological Chemistry · doi:10.1074/jbc.m117.778308 · Cited by 444 · see citing works
Dunkel, N., Blaß, J., Rogers, P. D., & Morschhäuser, J. (2008) · Molecular Microbiology · doi:10.1111/j.1365-2958.2008.06309.x · Cited by 278 · see citing works
Healey, K. R., Zhao, Y., Perez, W. B., Lockhart, S. R., Sobel, J. D., Farmakiotis, D., Kontoyiannis, D. P., Sanglard, D., Taj-Aldeen, S. J., Alexander, B. D., et al. (2016) · Nature Communications · doi:10.1038/ncomms11128 · Cited by 276 · see citing works
Self-citationThe genetic basis of fluconazole resistance development in Candida albicans
Morschhäuser, J. (2002) · Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease · doi:10.1016/s0925-4439(02)00087-x · Cited by 236 · see citing works
Recurrent Vulvovaginal Candidiasis
Sobel, J. D. (1986) · New England Journal of Medicine · doi:10.1056/nejm198612043152305 · Cited by 219 · see citing works
Self-citationEdwards, J. E., Schwartz, M. M., Schmidt, C. S., Sobel, J. D., Nyirjesy, P., Schodel, F., Marchus, E., Lizakowski, M., DeMontigny, E. A., Hoeg, J., et al. (2018) · Clinical Infectious Diseases · doi:10.1093/cid/ciy185 · Cited by 213 · see citing works
Self-citationCalabrese, D. R., Billé, J., & Sanglard, D. (2000) · Microbiology · doi:10.1099/00221287-146-11-2743 · Cited by 210 · see citing works
Treatment of vaginitis caused by Candida glabrata: use of topical boric acid and flucytosine
Sobel, J. D., Chaim, W., Nagappan, V., & Leaman, D. (2003) · American Journal of Obstetrics and Gynecology · doi:10.1067/s0002-9378(03)00726-9 · Cited by 206 · see citing works
Self-citationFluconazole-Resistant Candida albicans Vulvovaginitis
Marchaim, D., Lemanek, L., Bheemreddy, S., Kaye, K. S., & Sobel, J. D. (2012) · Obstetrics & Gynecology · doi:10.1097/aog.0b013e31827307b2 · Cited by 195 · see citing works
Self-citationChau, A. S., Mendrick, C. A., Sabatelli, F. J., Loebenberg, D., & McNicholas, P. M. (2004) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.48.6.2124-2131.2004 · Cited by 187 · see citing works
Novel Agents and Drug Targets to Meet the Challenges of Resistant Fungi
McCarthy, M. W., Kontoyiannis, D. P., Cornely, O. A., Perfect, J. R., & Walsh, T. J. (2017) · The Journal of Infectious Diseases · doi:10.1093/infdis/jix130 · Cited by 171 · see citing works
Karababa, M., Coste, A. T., Rognon, B., Billé, J., & Sanglard, D. (2004) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.48.8.3064-3079.2004 · Cited by 161 · see citing works
Rogers, P. D., & Barker, K. S. (2003) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.47.4.1220-1227.2003 · Cited by 157 · see citing works
Molecular analysis of cyp51 from fluconazole-resistant Candida albicans strains
Löffler, J., Kelly, S. L., Hebart, H. F., Schumacher, U., Lass‐Flörl, C., & Einsele, H. (2006) · FEMS Microbiology Letters · doi:10.1111/j.1574-6968.1997.tb12580.x · Cited by 143 · see citing works
Infection Due to Fluconazole-Resistant Candida in Patients with AIDS: Prevalence and Microbiology
Maenza, J. R., Merz, W. G., Romagnoli, M., Keruly, J. C., Moore, R. D., & Gallant, J. E. (1997) · Clinical Infectious Diseases · doi:10.1093/clinids/24.1.28 · Cited by 141 · see citing works
Vulvovaginal Candidiasis Caused by Non-albicans Candida Species: New Insights
Kennedy, M. A., & Sobel, J. D. (2010) · Current Infectious Disease Reports · doi:10.1007/s11908-010-0137-9 · Cited by 130 · see citing works
Self-citationDonders, G., Bellen, G., Byttebier, G., Verguts, L., Hinoul, P., Walckiers, R., Stalpaert, M., Vereecken, A., & Van Eldere, J. (2008) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2008.06.029 · Cited by 127 · see citing works
Jiménez‐Ortigosa, C., Paderu, P., Motyl, M. R., & Perlin, D. S. (2013) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.02145-13 · Cited by 122 · see citing works
Antifungal mechanisms supporting boric acid therapy of Candida vaginitis
Seta, F. D., Schmidt, M., Vu, B., Essmann, M., & Larsen, B. (2008) · Journal of Antimicrobial Chemotherapy · doi:10.1093/jac/dkn486 · Cited by 119 · see citing works
Molecular analysis of cyp51 from fluconazole-resistant Candida albicans strains
Löffler, J. (1997) · FEMS Microbiology Letters · doi:10.1016/s0378-1097(97)00172-9 · Cited by 119 · see citing works
Morschhäuser, J. (2016) · Journal of Microbiology · doi:10.1007/s12275-016-5628-4 · Cited by 118 · see citing works
Boric Acid for Recurrent Vulvovaginal Candidiasis: The Clinical Evidence
Iavazzo, C. R., Gkegkes, I. D., Zarkada, I. M., & Falagas, M. E. (2011) · Journal of Women s Health · doi:10.1089/jwh.2010.2708 · Cited by 105 · see citing works
Refractory Mucosal Candidiasis in Advanced Human Immunodeficiency Virus Infection
Fichtenbaum, C. J., Koletar, S. L., Yiannoutsos, C. T., Holland, F., Pottage, J. C., Cohn, S. E., Walawander, A., Frame, P. T., Feinberg, J., Saag, M. S., et al. (2000) · Clinical Infectious Diseases · doi:10.1086/313765 · Cited by 99 · see citing works
Vaginitis Due to Candida krusei: Epidemiology, Clinical Aspects, and Therapy
Singh, S., Sobel, J. D., Bhargava, P., Boikov, D. A., & Vazquez, J. A. (2002) · Clinical Infectious Diseases · doi:10.1086/343826 · Cited by 97 · see citing works
Self-citationSchuetzer‐Muehlbauer, M. (2003) · International Journal of Antimicrobial Agents · doi:10.1016/s0924-8579(03)00213-9 · Cited by 97 · see citing works
Lepak, A. J., Marchillo, K., & Andes, D. R. (2014) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.04445-14 · Cited by 95 · see citing works
Patel, P., Erlandsen, J. E., Kirkpatrick, W. R., Berg, D. K., Westbrook, S. D., Louden, C., Cornell, J. E., Thompson, G. R., Vallor, A. C., Wickes, B. L., et al. (2012) · AIDS Research and Treatment · doi:10.1155/2012/262471 · Cited by 85 · see citing works
Garvey, E. P., HOEKSTRA, W., Schotzinger, R. J., Sobel, J. D., Lilly, E. A., & Fidel, P. L. (2015) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.00185-15 · Cited by 83 · see citing works
Self-citationBhattacharya, S., Sobel, J. D., & White, T. C. (2016) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.01252-16 · Cited by 83 · see citing works
Self-citationSchell, W. A., Jones, A. M., Garvey, E. P., Hoekstra, W. J., Schotzinger, R. J., & Alexander, B. D. (2017) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.01817-16 · Cited by 74 · see citing works
Mechanisms of resistance to azole antifungals.
Marichal, P., & BOSSCHE, H. V. (1995) · Acta Biochimica Polonica · doi:10.18388/abp.1995_4904 · Cited by 72 · see citing works
Sobel, J. D., & Vazquez, J. A. (1996) · Clinical Infectious Diseases · doi:10.1093/clinids/22.4.726 · Cited by 63 · see citing works
Self-citationCombined topical flucytosine and amphotericin B for refractory vaginal Candida glabrata infections
White, D. (2001) · Sexually Transmitted Infections · doi:10.1136/sti.77.3.212 · Cited by 62 · see citing works
Choukri, F., Benderdouche, M., & Sednaoui, P. (2014) · Journal de Mycologie Médicale · doi:10.1016/j.mycmed.2014.05.001 · Cited by 60 · see citing works
High Oral Carriage of Non- albicans Candida spp. among HIV-infected individuals
Mushi, M. F., Mtemisika, C. I., Bader, O., Bii, C. C., Mirambo, M. M., Groß, U., & Mshana, S. E. (2016) · International Journal of Infectious Diseases · doi:10.1016/j.ijid.2016.07.001 · Cited by 58 · see citing works
Martins, M. D., Lozano‐Chiu, M., & Rex, J. H. (1997) · Clinical Infectious Diseases · doi:10.1086/515554 · Cited by 54 · see citing works
Establishing Surrogate Markers for FluconazoleResistance in Candida albicans
Park, S., & Perlin, D. S. (2005) · Microbial Drug Resistance · doi:10.1089/mdr.2005.11.232 · Cited by 52 · see citing works
Zhang, J., Liu, J., Liu, F., Xia, Y., Wang, J., Xi, L., Zhang, Z., Zhu, N., Yanyan, Ying, Y., et al. (2014) · Mycoses · doi:10.1111/myc.12204 · Cited by 50 · see citing works
Rad, K., Falahati, M., Roudbary, M., Farahyar, S., & Nami, S. (2016) · Current Medical Mycology · doi:10.18869/acadpub.cmm.2.4.24 · Cited by 46 · see citing works
Manoharlal, R., Gaur, N. A., Panwar, S. L., Morschhäuser, J., & Prasad, R. (2008) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.01106-07 · Cited by 43 · see citing works
Management of persistent vulvo vaginal candidosis due to azole-resistant Candida glabrata.
White, D., Johnson, E. M., & Warnock, D. W. (1993) · Sexually Transmitted Infections · doi:10.1136/sti.69.2.112 · Cited by 40 · see citing works
Fungal Profile of Vulvovaginal Candidiasis in a Tertiary Care Hospital
Kalaiarasan, K. (2017) · JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH · doi:10.7860/jcdr/2017/23578.9475 · Cited by 36 · see citing works
Break, T. J., Desai, J. V., Natarajan, M., Ferre, E. M. N., Henderson, C., Zelazny, A. M., Siebenlist, U., Hoekstra, W. J., Schotzinger, R. J., Garvey, E. P., et al. (2018) · Journal of Antimicrobial Chemotherapy · doi:10.1093/jac/dkx352 · Cited by 34 · see citing works
Clark-Ordóñez, I., Callejas-Negrete, O. A., Aréchiga‐Carvajal, E. T., & Mouriño-Pérez, R. R. (2016) · Medical Mycology · doi:10.1093/mmy/myw069 · Cited by 29 · see citing works
de Vasconcelos, S. S. N., Fiorini, A., Zanni, P., Mendonca, P., Godoy, J. R., de Almeida-Apolonio, A. A., Consolaro, M. E. L., & Svidzinski, T. I. E. (2017) · Archives of Gynecology and Obstetrics · doi:10.1007/s00404-017-4465-y · Cited by 29 · see citing works
GÜLAT, S., & Dereli, M. D. (2014) · Mikrobiyoloji Bulteni · doi:10.5578/mb.7213 · Cited by 14 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Vulvovaginal Candidiasis: A Current Understanding and Burning Questions
Willems, H. M. E., Ahmed, S. S., Liu, J., Xu, Z., & Peters, B. M. (2020) · Journal of Fungi · doi:10.3390/jof6010027 · Cited by 357 · see citing works
Role of Vaginal Microbiota Dysbiosis in Gynecological Diseases and the Potential Interventions
Han, Y., Liu, Z., & Chen, T. (2021) · Frontiers in Microbiology · doi:10.3389/fmicb.2021.643422 · Cited by 144 · see citing works
Vaginitis in Nonpregnant Patients
(2019) · Obstetrics and Gynecology · doi:10.1097/aog.0000000000003604 · Cited by 101 · see citing works
Martens, M. G., Maximos, B., Degenhardt, T., Person, K., Curelop, S., Ghannoum, M., Flynt, A., & Brand, S. R. (2022) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2022.07.023 · Cited by 86 · see citing works
Oteseconazole: An Advance in Treatment of Recurrent Vulvovaginal Candidiasis
Sobel, J. D., & Nyirjesy, P. (2021) · Future Microbiology · doi:10.2217/fmb-2021-0173 · Cited by 78 · see citing works
Self-citationDonders, G., Sziller, I. O., Paavonen, J., Hay, P., de Seta, F., Bohbot, J. M., Kotarski, J., Vives, J. A., Szabo, B., Cepuliené, R., et al. (2022) · Frontiers in Cellular and Infection Microbiology · doi:10.3389/fcimb.2022.934353 · Cited by 82 · see citing works
Li, T., Liu, Z., Zhang, X., Chen, X., & Wang, S. (2019) · Frontiers in Microbiology · doi:10.3389/fmicb.2019.01033 · Cited by 66 · see citing works
Vaginitis in Nonpregnant Patients: ACOG Practice Bulletin Number 215
Paavonen, J. A., & Brunham, R. C. (2020) · Obstetrics and Gynecology · doi:10.1097/aog.0000000000003857 · Cited by 59 · see citing works
Clinical challenges in diagnosis and treatment of recurrent vulvovaginal candidiasis
Neal, C. M., & Martens, M. G. (2022) · SAGE Open Medicine · doi:10.1177/20503121221115201 · Cited by 56 · see citing works
Collins, L. M., Moore, R., & Sobel, J. D. (2020) · Journal of Lower Genital Tract Disease · doi:10.1097/lgt.0000000000000496 · Cited by 55 · see citing works
Self-citationIn Vitro and In Vivo Anti-Candida spp. Activity of Plant-Derived Products
Pedroso, R. D. S., Balbino, B. L., Andrade, G., Dias, M. C., Alvarenga, T. A., Pedroso, R. C. N., Pimenta, L. P., Lucarini, R., Pauletti, P. M., Januário, A. H., et al. (2019) · Plants · doi:10.3390/plants8110494 · Cited by 54 · see citing works
Efficacy and Safety of Oteseconazole in Recurrent Vulvovaginal Candidiasis
Sobel, J. D., Donders, G., Degenhardt, T., Person, K., Curelop, S., Ghannoum, M., & Brand, S. R. (2022) · NEJM Evidence · doi:10.1056/evidoa2100055 · Cited by 55 · see citing works
Self-citationSobel, J. D. (2023) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.00181-23 · Cited by 53 · see citing works
Self-citationOral Ibrexafungerp: An Investigational Agent for the Treatment of Vulvovaginal Candidiasis
Azie, N., Angulo, D., Dehn, B., & Sobel, J. D. (2020) · Expert Opinion on Investigational Drugs · doi:10.1080/13543784.2020.1791820 · Cited by 46 · see citing works
Self-citationVanić, Ž., Jøraholmen, M. W., & Škalko‐Basnet, N. (2021) · Advanced Drug Delivery Reviews · doi:10.1016/j.addr.2021.113855 · Cited by 46 · see citing works
Targeting Virulence Factors of Candida albicans with Natural Products
Bu, Q., Bao, M.-Y., Yang, Y., Wang, T.-M., & Wang, C. (2022) · Foods · doi:10.3390/foods11192951 · Cited by 46 · see citing works
Wu, M., Xu, X., Hu, R. M., Chen, Q., Chen, L., Yuan, Y., Li, J., Zhou, L., Feng, S., Wang, L., et al. (2023) · Advanced Science · doi:10.1002/advs.202207736 · Cited by 43 · see citing works
Harley, B. K., Neglo, D., Tawiah, P. A., Pipim, M. A., Mireku-Gyimah, N. A., Tettey, C. O., Amengor, C. D. K., Fleischer, T. C., & Waikhom, S. D. (2021) · PLoS ONE · doi:10.1371/journal.pone.0260956 · Cited by 40 · see citing works
dos Santos, C. I., Campos, C. D. L., Neto, W. R. N., do Carmo, M. S., Nogueira, F. A. B., Ferreira, R. M., Costa, E. P. D. S., Gonzaga, L. F., Araújo, J. M. M., Monteiro, J. D. M., et al. (2021) · Journal of Fungi · doi:10.3390/jof7100794 · Cited by 38 · see citing works
Enggi, C. K., Sulistiawati, S., Stephanie, S., Tangdilintin, F., Achmad, A. A., Putri, R. A., Burhanuddin, H., Arjuna, A., Manggau, M. A., & Permana, A. D. (2023) · Journal of Colloid and Interface Science · doi:10.1016/j.jcis.2023.05.165 · Cited by 38 · see citing works
Vulvovaginal candidiasis: An overview of mycological, clinical, and immunological aspects
Jafarzadeh, L., Ranjbar, M., Nazari, T., Eshkaleti, M. N., Gharehbolagh, S. A., Sobel, J. D., & Mahmoudi, S. (2022) · Journal of obstetrics and gynaecology research · doi:10.1111/jog.15267 · Cited by 37 · see citing works
Self-citationPowell, A. M., Ghanem, K. G., Rogers, L. C., Zinalabedini, A., Brotman, R. M., Zenilman, J. M., & Tuddenham, S. (2019) · Sexually Transmitted Diseases · doi:10.1097/olq.0000000000001063 · Cited by 36 · see citing works
Distinct host immune responses in recurrent vulvovaginal candidiasis and vulvovaginal candidiasis
Ge, G., Yang, Z., Li, D., Zhang, N., Chen, B., & Shi, D. (2022) · Frontiers in Immunology · doi:10.3389/fimmu.2022.959740 · Cited by 35 · see citing works
Sharma, K., Parmanu, P. K., & Sharma, M. (2024) · Archives of Microbiology · doi:10.1007/s00203-023-03824-1 · Cited by 35 · see citing works
Vulvovaginal candidiasis-an overview of current trends and the latest treatment strategies
Bhosale, V. B., Koparde, A. A., & Thorat, V. M. (2025) · Microbial Pathogenesis · doi:10.1016/j.micpath.2025.107359 · Cited by 37 · see citing works
Candida africana vulvovaginitis: Prevalence and geographical distribution
Fakhim, H., Vaezi, A., Javidnia, J., Nasri, E., Mahdi, D., Diba, K., & Badali, H. (2020) · Journal de Mycologie Médicale · doi:10.1016/j.mycmed.2020.100966 · Cited by 33 · see citing works
Shi, Y., Zhu, Y., Fan, S., Liu, X., Liang, Y., & Shan, Y. (2020) · BMC Infectious Diseases · doi:10.1186/s12879-020-04985-w · Cited by 32 · see citing works
Paniágua, A. L., Correia, A. F., Pereira, L. C., de Alencar, B. M., Brandão, F., Almeida, R. M., & Nóbrega, Y. K. D. M. (2021) · BMC Complementary Medicine and Therapies · doi:10.1186/s12906-021-03405-z · Cited by 32 · see citing works
Seleno-Metabolites and Their Precursors: A New Dawn for Several Illnesses?
Morán‐Serradilla, C., Angulo-Elizari, E., Henriquez-Figuereo, A., Sanmartín, C., Sharma, A. K., & Plano, D. (2022) · Metabolites · doi:10.3390/metabo12090874 · Cited by 31 · see citing works
Lactobacillus rhamnosus AD3 as a promising alternative for probiotic products
Stivala, A., Carota, G., Fuochi, V., & Furneri, P. M. (2021) · Biomolecules · doi:10.3390/biom11010094 · Cited by 31 · see citing works
Fernandes, Â., Azevedo, N. F., Valente, A., Días, M., Gomes, A., Nogueira‐Silva, C., Henriques, M., Silva, S. M., & Gonçalves, B. (2022) · Medical Mycology · doi:10.1093/mmy/myac029 · Cited by 35 · see citing works
Malfa, P., Brambilla, L., Giardina, S., Masciarelli, M., Squarzanti, D. F., Carlomagno, F., & Méloni, M. (2023) · International Journal of Molecular Sciences · doi:10.3390/ijms24021323 · Cited by 30 · see citing works
A longitudinal study on fluconazole resistance in Candida albicans vaginal isolates
Sobel, J. D., Sebastian, S., & Boikov, D. A. (2023) · Mycoses · doi:10.1111/myc.13582 · Cited by 30 · see citing works
Self-citationHu, K., Zhang, H., Shi, G., Wang, B., Wu, D., Shao, J., Wang, T., & Wang, C. (2022) · Journal of Ethnopharmacology · doi:10.1016/j.jep.2022.116041 · Cited by 29 · see citing works
Ellagic Acid–Cyclodextrin Complexes for the Treatment of Oral Candidiasis
Sampaio, A. D. G., Gontijo, A. V. L., Lima, G. D. M. G., de Oliveira, M. A. C., Lepesqueur, L. S. S., & Koga‐Ito, C. Y. (2021) · Molecules · doi:10.3390/molecules26020505 · Cited by 29 · see citing works
Fluconazole-Resistant Vulvovaginal Candidosis: An Update on Current Management
Akinosoglou, K., Livieratos, A., Asimos, K., Donders, F., & Donders, G. G. G. (2024) · Pharmaceutics · doi:10.3390/pharmaceutics16121555 · Cited by 30 · see citing works
Skin Allergy to Azole Antifungal Agents for Systemic Use: A Review of the Literature
Calogiuri, G., Garvey, L. H., Nettis, E., Romita, P., Leo, E. D., Caruso, R., Butani, L., & Foti, C. (2019) · Recent Patents on Inflammation & Allergy Drug Discovery · doi:10.2174/1872213x13666190919162414 · Cited by 28 · see citing works
Antifungal Activity and Mode of Action of Miltefosine Against Clinical Isolates of Candida krusei
Wu, Y., Wu, M., Gao, J., & Ying, C. (2020) · Frontiers in Microbiology · doi:10.3389/fmicb.2020.00854 · Cited by 28 · see citing works
Spettel, K., Bumberger, D., Camp, I., Kriz, R., & Willinger, B. (2022) · Journal of Global Antimicrobial Resistance · doi:10.1016/j.jgar.2022.01.028 · Cited by 28 · see citing works
Singh, A., Kaur, K., Kaur, H., Mohana, P., Arora, S., Bedi, N., Chadha, R., & Bedi, P. M. S. (2022) · Journal of Molecular Structure · doi:10.1016/j.molstruc.2022.134456 · Cited by 28 · see citing works
Berberine Inhibits the Adhesion of Candida albicans to Vaginal Epithelial Cells
Zhao, T., Zhang, K., Shi, G., Ma, K., Wang, B., Shao, J., Wang, T., & Wang, C. (2022) · Frontiers in Pharmacology · doi:10.3389/fphar.2022.814883 · Cited by 27 · see citing works
Li, R., Wang, X., Yin, K., Xu, Q., Ren, S., Wang, X., Wang, Z., & Yi, Y. (2023) · Biochemical Pharmacology · doi:10.1016/j.bcp.2023.115535 · Cited by 26 · see citing works
New perspectives on the topical management of recurrent candidiasis
Ré, A. C. D. S., Martins, J. F., Filho, M. C., Gelfuso, G. M., Aires, C. P., & Gratieri, T. (2021) · Drug Delivery and Translational Research · doi:10.1007/s13346-021-00901-0 · Cited by 28 · see citing works
Shokoohi, G., Javidnia, J., Mirhendi, H., Jahromi, A. R., Rezaei‐Matehkolaei, A., Ansari, S., Maryami, F., Goodarzi, S., & Romeo, O. (2021) · Mycoses · doi:10.1111/myc.13280 · Cited by 22 · see citing works
Costa, K. M. N., Sato, M. R., Barbosa, T. L. A., Rodrigues, M. G. F., de Medeiros, A. C. D., Damasceno, B. P. G. D. L., & Oshiro, J. A. (2021) · Pharmaceutics · doi:10.3390/pharmaceutics13050675 · Cited by 21 · see citing works
Zhao, X., Sun, D., Zhang, A., Huang, H., Li, Y., & Xu, D. (2023) · Scientific Reports · doi:10.1038/s41598-022-25471-0 · Cited by 21 · see citing works
Assessment and Treatment of Vaginitis
Mitchell, C. M. (2024) · Obstetrics and Gynecology · doi:10.1097/aog.0000000000005673 · Cited by 22 · see citing works
A Comprehensive Overview of Candida albicans as the Leading Pathogen in Vulvovaginal Candidiasis
Srb, N., Talapko, J., Meštrović, T., Fureš, R., Stupnišek, M., Srb, A. M., & Škrlec, I. (2025) · Journal of Fungi · doi:10.3390/jof11090632 · Cited by 26 · see citing works
Intra, J., Sala, M. R., Brambilla, P., Carcione, D., & Leoni, V. (2022) · Journal de Mycologie Médicale · doi:10.1016/j.mycmed.2022.101278 · Cited by 22 · see citing works
File, B., Sobel, R., Becker, M., & Nyirjesy, P. (2023) · Journal of Lower Genital Tract Disease · doi:10.1097/lgt.0000000000000733 · Cited by 20 · see citing works
Self-citationNikoomanesh, F., Falahatinejad, M., Černáková, L., dos Santos, A. L. S., Mohammadi, S. R., Rafiee, M., Rodrigues, C. F., & Roudbary, M. (2023) · Medicina · doi:10.3390/medicina59040743 · Cited by 20 · see citing works
The effect of Aloe vera ethanol extract on the growth inhibition of Candida albicans
Nabila, V. K., & Putra, I. B. (2020) · Medicinski Glasnik · doi:10.17392/1098-20 · Cited by 19 · see citing works
Sodium bicarbonate gels: a new promising strategy for the treatment of vulvovaginal candidosis
Tomás, M., Rolo, J., Gaspar, C., Palmeira‐de‐Oliveira, A., Simões, S., Katz, D. F., Martinez‐de‐Oliveira, J., & Palmeira‐de‐Oliveira, R. (2020) · European Journal of Pharmaceutical Sciences · doi:10.1016/j.ejps.2020.105621 · Cited by 18 · see citing works
Chronic recurrent vulvovaginitis is not only due to Candida
Arechavala, A. I., Negroni, R., Santiso, G., Depardo, R., & Bonvehí, P. (2021) · Revista Iberoamericana de Micología · doi:10.1016/j.riam.2021.03.002 · Cited by 19 · see citing works
An Epidemiologic Analysis of Vulvovaginal Candidiasis and Antifungal Susceptibilities
Hösükoğlu, F. G., Ekşi, F., Erinmez, M., & Uğur, M. G. (2022) · Infectious Microbes & Diseases · doi:10.1097/im9.0000000000000095 · Cited by 18 · see citing works
Amini, F., Namjooyan, F., Zomorodian, K., Zareshahrabadi, Z., Shojaei, K., Jaladat, A. M., & Hashempur, M. H. (2023) · EXPLORE · doi:10.1016/j.explore.2023.04.005 · Cited by 17 · see citing works
Interpretation of vaginal metagenomic characteristics in different types of vaginitis
Song, J., Dong, X., Lan, Y., Lu, Y., Liu, X., Kang, X., Huang, Z., Yue, B., Liu, Y., Ma, W., et al. (2024) · mSystems · doi:10.1128/msystems.01377-23 · Cited by 17 · see citing works
Rolo, J., Faria-Gonçalves, P., Barata, T. S., Costa‐de‐Oliveira, S., Gaspar, C., Ferreira, S. S., Palmeira‐de‐Oliveira, R., Martinez‐de‐Oliveira, J., Costa‐de‐Oliveira, S., & Palmeira‐de‐Oliveira, A. (2021) · Microbial Drug Resistance · doi:10.1089/mdr.2020.0139 · Cited by 16 · see citing works
Feng, X. L., Zhang, H., Hu, K., Shi, G., Wu, D., Shao, J., Wang, T., & Wang, C. (2023) · Journal of Ethnopharmacology · doi:10.1016/j.jep.2023.116869 · Cited by 16 · see citing works
Żyrek, D., Wajda, A., Czechowicz, P., Nowicka, J., Jaśkiewicz, M., Neubauer, D., & Kamysz, W. (2021) · Antibiotics · doi:10.3390/antibiotics10081001 · Cited by 16 · see citing works
An, L., Tan, J., Wang, Y., Liu, S., Li, Y., & Yang, L. (2022) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.00725-22 · Cited by 17 · see citing works
Wychrij, D. A., Chapman, T. I., Rayens, E. A., Rabacal, W., Willems, H. M. E., Oworae, K. O., Peters, B. M., & Norris, K. A. (2025) · npj Vaccines · doi:10.1038/s41541-025-01171-4 · Cited by 15 · see citing works
Hassan, N., Farooq, U., Das, A. K., Sharma, K., Mirza, M. A., Fatima, S., Singh, O., Ansari, M. J., Ali, A., & Iqbal, Z. (2023) · ACS Omega · doi:10.1021/acsomega.2c07718 · Cited by 15 · see citing works
Vandecruys, P., Baldewijns, S., Sillen, M., Genechten, W. V., & Dijck, P. V. (2023) · Expert Review of Anti-infective Therapy · doi:10.1080/14787210.2023.2233696 · Cited by 15 · see citing works
Gerges, M., Fahmy, Y., Hosny, T., Gandor, N., Mohammed, S., Mohamed, T., Abdelmoteleb, N. E. M., & Esmaeel, N. E. (2023) · Infection and Drug Resistance · doi:10.2147/idr.s420580 · Cited by 8 · see citing works
Oteseconazole for the Treatment of Recurrent Vulvovaginal Candidiasis: A Drug Review
Lanier, C., & Melton, T. C. (2023) · Annals of Pharmacotherapy · doi:10.1177/10600280231195649 · Cited by 14 · see citing works
Zahedifard, T., Khadivzadeh, T., & Rakhshkhorshid, M. (2023) · Ethiopian Journal of Health Sciences · doi:10.4314/ejhs.v33i5.18 · Cited by 19 · see citing works
Silva, A. M., Rocha, B., Moreira, M. M., Delerue-Matos, C. M., das Neves, J., & Rodrigues, F. (2024) · International Journal of Molecular Sciences · doi:10.3390/ijms25052478 · Cited by 14 · see citing works
Hu, K., Jiang, X., Zhang, J., Xia, D., Wu, D., Shao, J., Wang, T., & Wang, C. (2024) · Phytomedicine · doi:10.1016/j.phymed.2024.155515 · Cited by 14 · see citing works
He, R. X., Lin, F., Yu, B., & Huang, L. (2024) · Heliyon · doi:10.1016/j.heliyon.2024.e28776 · Cited by 14 · see citing works
Štěpánek, O., Čmoková, A., Procházková, E., Grobárová, V., Černý, J., Slapničková, M., Zı́ková, A., Kolařík, M., & Baszczyňski, O. (2022) · ChemMedChem · doi:10.1002/cmdc.202200385 · Cited by 13 · see citing works
Ranđelović, M., Dimitrijević, M., Otašević, S., Stanojevic, L. P., Išljamović, M., Ignjatović, A., Arsić-Arsenijević, V. S., & Stojanović-Radić, Z. Z. (2023) · Journal of Fungi · doi:10.3390/jof9111080 · Cited by 14 · see citing works
Klotoé, J. R., Fanou, B. A., Agbodjento, E., Houehou, A., Fah, L., Dougnon, V. T., Assogba, P., & Loko, F. (2021) · Future Journal of Pharmaceutical Sciences · doi:10.1186/s43094-021-00383-4 · Cited by 13 · see citing works
Chen, Z., Luo, T., Huang, F., Yang, F., Luo, W., Chen, G., Cao, M., Wang, F., & Zhang, J. (2022) · Frontiers in Pharmacology · doi:10.3389/fphar.2021.816290 · Cited by 13 · see citing works
Goje, O., Azie, N. E., Angulo, D. A., Sobel, R., Nyirjesy, P., & Sobel, J. D. (2025) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2025.07.040 · Cited by 16 · see citing works
Self-citationCai, X., Kong, F., Wang, R., Zhai, S., Guan, X., Zhang, G., & Wang, D. (2019) · Future Microbiology · doi:10.2217/fmb-2018-0299 · Cited by 12 · see citing works
Fernandes, L., Gonçalves, B., Costa, R. H. S., Fernandes, Â., Gomes, A., Nogueira‐Silva, C., Silva, S. M., Rodrigues, M. E., & Henriques, M. (2022) · Healthcare · doi:10.3390/healthcare10091649 · Cited by 11 · see citing works
Ma, J., Yang, Y.-C., Su, L., Qin, D.-M., Yuan, K., Zhang, Y., & Wang, R.-R. (2021) · Letters in Applied Microbiology · doi:10.1111/lam.13641 · Cited by 10 · see citing works
Serafim, M. S., Rodrigues, D. M., Ribeiro, V. P., Ccana-Ccapatinta, G. V., Groppo, M., Martins, C. H. G., Ambrósio, S. R., & Bastos, J. K. (2022) · Natural Product Research · doi:10.1080/14786419.2022.2065486 · Cited by 10 · see citing works
Harley, B. K., Neglo, D., Aggrey, M. O., Quagraine, A. M., Orman, E., Jato, J., Mireku-Gyimah, N. A., Amengor, C. D. K., & Fleischer, T. C. (2022) · BioMed Research International · doi:10.1155/2022/4261741 · Cited by 10 · see citing works
Zeng, X., An, R., Li, H., & Zhang, Y. (2023) · Medicine · doi:10.1097/md.0000000000032664 · Cited by 9 · see citing works
The Increasing Trend of Triazole-Resistant Candida from Vulvovaginal Candidiasis
Li, L., Zhang, X., Li, Q., Zhong, W., & Zou, H. (2024) · Infection and Drug Resistance · doi:10.2147/idr.s474304 · Cited by 10 · see citing works
Kroustali, V., Kanioura, L., Resoulai, E., Siopi, M., Antonopoulou, S., & Meletiadis, J. (2025) · Microbiology Spectrum · doi:10.1128/spectrum.02488-24 · Cited by 9 · see citing works
Yang, X., Wang, M., Kang, X., Mo, F., Si, P., Ma, J., Zhang, P., Zheng, S., Li, J., Wang, Y., et al. (2022) · International Journal of Pharmaceutics · doi:10.1016/j.ijpharm.2022.121851 · Cited by 9 · see citing works
Zhang, H., Zhang, J., Wang, C., Wu, D., & Shi, G. (2023) · Future Microbiology · doi:10.2217/fmb-2023-0033 · Cited by 9 · see citing works
Meng, Q., Wang, H., Xiao, W., Mai, W., Liu, Y., Xiao, Y., Wang, P., Sui, J., He, X., Yin, F., et al. (2025) · Mycology · doi:10.1080/21501203.2025.2461725 · Cited by 8 · see citing works
Grando, D., & Watson, C. J. (2025) · Journal of Fungi · doi:10.3390/jof11110806 · Cited by 9 · see citing works
Role of Antifungal Susceptibility Tests in the Treatment of Vulvovaginal Candidiasis
Sobel, J. D. (2023) · Current Infectious Disease Reports · doi:10.1007/s11908-023-00797-6 · Cited by 8 · see citing works
Self-citationMartínez-García, E., Martínez-Martínez, J. C., Salvador, A. M., González‐García, A., Pérez‐Morente, M. Á., Álvarez‐Serrano, M. A., & García, I. G. (2023) · Pathogens · doi:10.3390/pathogens12060756 · Cited by 9 · see citing works
Campos, L. M., Lemos, A. S. D. O., Paula, P. D. L., Rocha, V. N., Araújo, M. G. D. F., Tavares, G. D., Barradas, T. N., Nascimento, W. W. G., Denadai, Â. M. L., de Oliveira, L. F. C., et al. (2024) · Colloids and Surfaces B Biointerfaces · doi:10.1016/j.colsurfb.2024.113919 · Cited by 7 · see citing works
Arrieta-Aguirre, I., Menéndez-Manjón, P., Carrano, G., Díez, A., Fernandez-de-Larrinoa, Í., & Moragues, M. D. (2023) · Journal of Fungi · doi:10.3390/jof9121145 · Cited by 7 · see citing works
Thamkhantho, M., & Chayachinda, C. (2020) · Archives of Gynecology and Obstetrics · doi:10.1007/s00404-020-05784-z · Cited by 7 · see citing works
Treatment of Recurrent Vulvovaginal Candidiasis With Ibrexafungerp
Grant, L. M., & Orenstein, R. (2022) · Journal of Investigative Medicine High Impact Case Reports · doi:10.1177/23247096221123144 · Cited by 7 · see citing works
Müller, M. L., Petersen, C. D., & Saunte, D. M. L. (2024) · Dermatologic Therapy · doi:10.1155/2024/2807070 · Cited by 6 · see citing works
Genetic diversity and antifungal resistance in Candida albicans from VVC cases in Indian women
Sahu, B. K., Mallick, U., Hegde, R., Turuk, J., Sahu, M. C., & Panda, S. K. (2025) · BMC Microbiology · doi:10.1186/s12866-025-04256-1 · Cited by 5 · see citing works
Recurrent Infectious Vaginitis
Yazdy, G. M., Mitchell, C. M., Sobel, J. D., & Tuddenham, S. (2023) · Medical Clinics of North America · doi:10.1016/j.mcna.2023.08.017 · Cited by 5 · see citing works
Self-citationKorabi, M. N. A., Mirmolaei, S. T., Tabarrai, M., Attar, S. M. G., Lamardi, S. N. S., & Haghani, S. (2022) · Evidence-based Complementary and Alternative Medicine · doi:10.1155/2022/1739729 · Cited by 5 · see citing works
Wang, X., Wang, W., Li, J., An, R., Chen, L., Lin, J., Xu, D., Qiu, J., Song, W., Patiman, M., et al. (2024) · Infection · doi:10.1007/s15010-024-02233-w · Cited by 5 · see citing works
Barberi, G., Biscari, G., Catania, V., Punginelli, D., Scialabba, C., Fiorica, C., Schillaci, D., & Cavallaro, G. (2024) · Journal of Drug Delivery Science and Technology · doi:10.1016/j.jddst.2024.106054 · Cited by 5 · see citing works
Teixeira, A. D. R., Quaresma, A. V., Branquinho, R. T., Oliveira, P. C. D., Suárez, J. A. G., Brandão, G. C., Barboza, A. P. M., Araújo, M. G. D. F., de Magalhães, J. T., de Moura, S. A. L., et al. (2025) · AAPS PharmSciTech · doi:10.1208/s12249-025-03081-z · Cited by 5 · see citing works
- Authors
- Sobel, J. D., & Sobel, R.
- Affiliations
- Wayne State University (US)
- Thomas Jefferson University Hospital (US)
- Corresponding author
- Sobel, J. D.
- Venue
- Expert Opinion on Pharmacotherapy
- Publisher
- Informa UK Limited
- Published
- 2018-06-13
- Volume
- 19
- Issue
- 9
- Pages
- 971-977
- ISSN
- 1465-6566 (ISSN-L)
- 1744-7666
- OpenAlex
- W2809133082
- Cited by
- 168
- References
- 56
- Citations by year
- 2026: 11 · 2025: 19 · 2024: 24 · 2023: 39 · 2022: 34 · 2021: 20 · 2020: 13 · 2019: 7 · 2018: 1
- FWCI
- 1.50
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Expert Opinion on Pharmacotherapy (publishedVersion)
- PubMed (publishedVersion)
- Funders
- not funded
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
- Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
- Life Sciences › Agricultural and Biological Sciences › Ecology, Evolution, Behavior and Systematics › Fungal Plant Pathogen Control
- Keywords
- vaginal candidiasis, azole resistance, Candida albicans, fluconazole resistance, non-albicans Candida, antifungal resistance, Candida vaginitis
- MeSH terms
- Antifungal Agents, Boric Acids, Candida, Candidiasis, Vulvovaginal, Female, Humans, Microbial Sensitivity Tests, Fluconazole, Drug Resistance, Fungal, 14-alpha Demethylase Inhibitors
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
