gynecology and obstetrics
Candidal Vaginitis
Treatment of Candidal Vaginitis
Antifungal medications (fluconazolein a single oral dose preferred) Avoidance of excess moisture accumulation Keeping the vulva dry and wearing loose, absorbent cotton clothing that allows air to circulate can reduce vulvar moisture and fungal growth. Topical or oral medications are highly effective for candidal vaginitis (see table). Adherence to treatment is better when a one-dose oral regimen offluconazole150 mg is used. New oral antifungal medications to treat candidal vaginitis includeibrexafungerpandoteseconazole. Clinical use of these varies. Some experts advise treatment with these antifungals in symptomatic patients who fail topical azoles and/or oralfluconazoleas documented by saline microscopy or fungal culture. Topicalbutoconazole,clotrimazole,miconazole, andtioconazoleare available over the counter. However, patients should be warned that topical creams and ointments containingmineral oilor vegetable oil weaken latex-based condoms and diaphragms. If symptoms persist or worsen during topical therapy, hypersensitivity to topical antifungals should be considered. 100 mg once a day for 6 months) ( Treatment reference ). Suppression is effective only while the medications are being taken. These medications may be contraindicated in patients with liver disorders. Patients taking 1.Sobel JD, Wiesenfeld HC, Martens M, et al: Maintenancefluconazoletherapy for recurrent vulvovaginal candidiasis.N Engl J Med351(9):876-883, 2004. doi:10.1056/NEJMoa033114 