How is Candidiasis treated?

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Uncomplicated  Vulvovaginal Candidiasis is easy to treat with short courses (single dose and regimens of 1-3 days) of topical antifungal agents with about an 80-90% success rate.

Recommended Regimens

Intravaginal Agents: Clotrimazole 1% cream 5 g intravaginally for 7–14 days*  OR Clotrimazole 100 mg vaginal tablet for 7 days  OR Clotrimazole 100 mg vaginal tablet, two tablets for 3 days  OR Miconazole2% cream 5 g intravaginally for 7 days*  OR Miconazole 100 mg vaginal suppository, one suppository for 7 days*  OR  Miconazole 200 mg vaginal suppository, one suppository for 3 days* OR Miconazole 1,200 mg vaginal suppository, one suppository for 1 day*

Oral Agent: Fluconazole 150 mg oral tablet, one tablet in single dose

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 consult their GP.  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.

Complicated Vulvovaginal Candidiasis: Women with underlying debilitating medical conditions (e.g., those with uncontrolled diabetes or those receiving cor-ticosteroid treatmen and pregnant woment) do not respond as well to short-term therapies. Efforts to correct modifiable conditions should be made, and more prolonged (i.e., 7–14 days) conventional antimycotic treatment is necessary.

Non Candida Vulvovaginal Candidiasis: The optimal treatment of nonalbicans VVC remains unknown. Options include longer duration of therapy (7–14 days) with a nonfluconazole azole drug (oral or topical) as first-line therapy. If recurrence occurs referral to a specialist is advised.

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