Vulvo-vaginal Candidiasis (Antimicrobial)
- All topical and oral azoles give 75% cure.
- First episode can be treated empirically.
- For recurrent or persistent symptoms, full assessment should be performed including: examination, high vaginal swab, and STI screening to include chlamydia, gonorrhoea, HIV and syphilis.
Give general skin care and washing advice - information leaflet available here.
Refer to Highland Sexual Health for problematic, recurrent or persistent infection.
Drug details
Uncomplicated symptomatic vaginal candidiasis
Clotrimazole 500mg pessary or 5g of 10% vaginal cream
As a single dose
OR Fluconazole 150mg
As a single dose
In pregnancy avoid oral azole, eg fluconazole
Clotrimazole 500mg pessary at night
Up to 7 nights
Severe infection
Clotrimazole pessary 500mg on days 1 and 4
OR
Fluconazole 150mg tablet on days 1 and 4
Recurrent infection
Induction - Fluconazole 150mg tablet on days 1, 4 and 7. Maintenance for 6 months: Fluconazole 150mg tablet weekly
Alternative induction - Clotrimazole 200mg pessary daily for 7 to 14 days. Maintenance for 6 months: Clotrimazole pessary 500mg weekly.