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


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.

Editorial Information

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