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TAM (Treatments and Medicines) NHS Highland
ADULT THERAPEUTIC GUIDELINES
ANTIMICROBIAL GUIDANCE
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Genital tract (Antimicrobial)
Vulvo-vaginal Candidiasis (Antimicrobial)

Update your RDS mobile app to v4.7.2 to download toolkits even when website is down.

We are pleased to advise that deep linking capability, enabling users to directly download individual mobile toolkits, has now been released on the RDS mobile app. You will see that each toolkit has a small QR code icon in the header area beside the search icon – see screenshot below. Clicking on this icon will open up a window with a full-size QR code and the alternative of a short URL for sharing with users. Instructions are provided.

You may need to actively update to the latest release - RDS app version 4.7.1 - to see this improvement.

Updating to this latest version of the RDS app is also strongly recommended to get the full benefits of the new resilience arrangements – specifically, that if the RDS website should fail, you will still be able to download new mobile app toolkits. To check your current RDS version, click on the three dots bottom right of the RDS app screen. This takes you to a “More” page where you will see the version number. To install latest updates:

On iPhones – go to the Apple store, click on your profile icon top right, scroll down to see the apps waiting to be updated and update the RDS app.

On Android phones – these can vary, but try going to the Google Play store, click on your profile icon top right, click on “Manage apps and device”, select and update the RDS app.

Please get in touch with ann.wales3@nhs.scot with any questions.

Vulvo-vaginal Candidiasis (Antimicrobial)

TAM (Treatments and Medicines) NHS Highland

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.

Last reviewed: 27/02/2023

Next review date: 27/02/2026

Author(s): Antimicrobial Management Team.

Approved By: TAM Subgroup of ADTC

Reviewer name(s): Alison Macdonald, Area Antimicrobial Pharmacist.

Document Id: AMT130