Vulvovaginal Candidiasis
Over the counter intravaginal agentsTreatment consist of ONE of the following regimens
Monistat (miconazole), Gyne-Lotrimin (clotrimazole) 7 to 14 day treatments Clotrimazole 1% cream 5 grams intravaginally daily for 7 to 14 days Miconazole 2% cream 5 grams intravaginally daily for 7 days Miconazole 100 mg vaginal suppository, once suppository daily for 7 days 3 day treatments Clotrimazole 2% cream 5 grams intravaginally daily for 3 days Miconazole 4% cream 5 grams intravaginally daily for 3 days Miconazole 200 mg vaginal suppository, one suppository for 3 days 1 day treatment Miconazole 1,200 mg vaginal suppository, one suppository for 1 day Prescription intravaginal agents Terconazole 0.4% cream 5 grams intravaginally daily for 7 days Terconazole 0.8% cream 5 grams intravaginally daily for 3 days Terconazole 80 mg vaginal suppository, one suppository daily for 3 days Fluconazole 150 mg orally in a single dose Follow up: Women should follow up with their primary care doctor if they have persistent symptoms after over completing the counter preparation or have recurrence of symptoms within 2 months after treatment. Pregnant Women
Topical azole therapy is recommended for 7 days
Management of Partners
Uncomplicated vulvovaginal candidiasis is not acquired through sexual intercourse. Men may have irritation or redness on the penis which could benefit from treatment but partners are not usually treated.
Women with HIV InfectionNo treatment differences
Long term preventative therapy with fluconazole 200 mg orally once weekly might be necessary to reduce the reoccurance, symptoms, and bacteria colonization |
Trichomonal VaginitisTreatmentMetronidazole 2 grams orally as a single dose
Alcohol consumption should be avoided during and 24 hours after treatment due to nausea, vomiting, and uncomfortable side effects. Follow up for sexually active people should be within 3 months Women with HIV Infection
Metronidazole 500 mg orally twice a day for 7 days
Treatment of Sex Partners
Make sure your sex partners get treated. Wait until symptoms go away (around one week) before having sex. Trichomoniasis can be cured but reinfections due occur so get checked out again if symptoms come back.
Bacterial VaginosisRecommended TreatmentMetronidazole 500 mg orally twice daily for 7 days
OR Metronidazole gel 0.75%, one full applicator (5 grams) intravaginally, once a day for 5 days OR Clindamycin cream 2%, one full applicator (5 grams) intravaginally at bedtime for 7 days Alcohol consumption should be avoided during and 24 hours after therapy. The cream and gel might weaken latex condoms. Refrain from sexual intercourse during the treatment regimen. Douching might increase the risk of recurrence and does not treat symptoms. Follow up: All women with bacterial vaginosis should be tested for HIV and STDs Alternative Treatment
Clindamycin 300 mg orally twice daily for 7 days
OR Clindamycin ovules 100 mg intravaginally once at bedtime for 3 days Clindamycin ovules might weaken condoms. Avoid use of products and sexual intercourse for 72 hours after completion of the regimen. Pregnant Women
Symptomatic pregnant women can be treated with oral or vaginal regimens
Management of Partners
Routine treatment of sex partners is not recommended.
Women with HIV Infection
Same treatment regimen as those who do not have HIV infection
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