Background & Objectives: The rising prevalence of recurrent Vulvovaginal Candidiasis (VVC) and the emergence of Non-Albicans Candida (NAC) species have complicated standard treatment protocols. While Fluconazole remains the primary clinical choice and Amphotericin B serves as a potent alternative, there is a growing interest in botanical antifungal agents [1-4]. This study evaluates the distribution of vaginal yeast isolates and compares the in vitro susceptibility profiles of two conventional antifungals against the medicinal fern Hansraj (Adiantum capillus-veneris) [5].

Methods: Vaginal swabs were collected from symptomatic VVC patients. Isolates were identified using CHROM agar. Species identification was performed using standard microbiological techniques and Germ Tube tests. The Minimum Inhibitory Concentration (MIC) for Fluconazole, Amphotericin B, and Hansraj (methanolic extract) was determined using the CLSI M27-A3 broth microdilution method. For Hansraj, a concentration range of 0.5 mg/mL to 64 mg/mL was utilized, while standard ranges were used for the chemical agents.

Results: A total of [Insert Number] isolates were analyzed, with Candida albicans (62%) being the most frequent, followed by C. glabrata (22%) and C. krusei (8%). •Fluconazole: Showed high resistance in NAC species (up to 40%) and a significant "trailing effect" in 15% of C. albicans isolates. •Amphotericin B: Demonstrated the highest potency, with 96% of all isolates being highly susceptible (MIC 1ug/mL). •Hansraj Extract: This agent demonstrated the highest potency. 96% of all isolates (including NAC) were susceptible with MICs ranging from 0.031 to 1.0 ug/mL. Only 2 isolates of C. albicans showed an MIC of 2.0 ug/mL (Intermediate).

Conclusion: While Amphotericin B remains the most effective agent in vitro, its clinical use is limited by potential toxicity. The high rate of Fluconazole resistance among NAC isolates underscores the need for alternative therapies. Hansraj extract showed significant inhibitory effects against both albicans and non-albicans species, suggesting its potential as a complementary or alternative phytotherapy for resistant VVC cases. Further studies are required to isolate the specific bioactive terpenoids responsible for this activity.