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Candidal vulvovaginitis
Classification and external resources
MeSH D002181

Candidal vulvovaginitis is an infection of the vaginal mucous membranes by Candida albicans.[1]:309

Treatment

Following are alternatives of recommended regimens, according to the CDC guidelines 2006.[2] The * denotes drugs that are available over-the-counter. Intravaginal Agents:

  • Butoconazole, only one dose of cream is required.[3]
    • 2% cream 5 g intravaginally for 3 days*
    • 2% cream 5 g (Butaconazole1-sustained release), single intravaginal application
  • Clotrimazole
    • 1% cream 5 g intravaginally for 7–14 days*, given twice a day, in the morning and evening[4]
    • 100 mg vaginal tablet at night before sleep[5] for 7 days
    • Clotrimazole 100 mg vaginal tablet, two tablets (at bedtime[6]) for 3 days
  • Miconazole
    • 2% cream 5 g intravaginally for 7 days*
    • 100 mg vaginal suppository, one suppository for 7 days*
    • 200 mg vaginal suppository, one suppository for 3 days*
    • 1,200 mg vaginal suppository, one suppository for 1 day*
  • Nystatin 100,000-unit vaginal tablet, one (or two[7]) tablet(s) a day for 14 days
  • Tioconazole 6.5% ointment 5 g intravaginally in a single application*
  • Terconazole
    • 0.4% cream 5 g intravaginally for 7 days
    • 0.8% cream 5 g intravaginally for 3 days
    • 80 mg vaginal suppository, one suppository for 3 days

Oral Agent:

  • Fluconazole 150 mg oral tablet, one tablet in single dose

Short-course topical formulations (i.e., single dose and regimens of 1–3 days) effectively treat uncomplicated VVC. The topically applied azole drugs are more effective than nystatin. Treatment with azoles results in relief of symptoms and negative cultures in 80%–90% of patients who complete therapy. [2]

The creams and suppositories in this regimen are oil-based and might weaken latex condoms and diaphragms. Refer to condom product labeling for further information. Intravaginal preparations of butaconazole, clotrimazole, miconazole, and tioconazole are available over-the-counter (OTC). Women whose condition has previously been diagnosed with VVC are not necessarily more likely to be able to diagnose themselves; therefore, any woman whose symptoms persist after using an OTC preparation, or who has a recurrence of symptoms within 2 months, should be evaluated with office-based testing. Unnecessary or inappropriate use of OTC preparations is common and can lead to a delay in the treatment of other vulvovaginitis etiologies, which can result in adverse clinical outcomes.[2]

See also

References

  1. ^ James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: clinical Dermatology. Saunders Elsevier. ISBN 0-7216-2921-0. 
  2. ^ a b c Sexually Transmitted Diseases Treatment Guidelines, 2006 Centers for Disease Control and Prevention. MMWR 2006;55
  3. ^ drugs.com > Butoconazole Cream Retrieved on Jan 22, 2010
  4. ^ drugs.com > clotrimazole cream Retrieved on Jan 22, 2010
  5. ^ sizainternational.com > Clotrimazole USP Tablets Retrieved on Jan 22, 2010
  6. ^ http://www.ncbi.nlm.nih.gov/pubmed/6682063 PMID: 6682063
  7. ^ drugs.com > nystatin (Vaginal route) Retrieved on Jan 23, 2010







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