Vulvovaginal Candidiasis

Incidence : 70-75% lifetime prevalence Etiology - 85-95% Candida albicans - 10-20% Candida glabrata - rest other strains Risk - medical Hx : DM, pregnancy, factors immunosuppressed - drug Hx: OC pills, IUCD,antibiotics, steorid - social hx : sexual hx & behavior( orogenital) Ddx : bacterial vaginosis, STD ( eg trichomonas)

Uncomplicated

Rx 40-50% recur

Complicated (severe disease, not caused by C albicans, abnormal host )

Rx

Canesten 100mg daily PV x 1/52 or Fluconazole 150mg po x 1 dose ( all oral/ topical agents have similar effectiveness)

5-8%
Recurrent Vulvovaginal Candidiasis ( defined as > 4 symptomatic episodes / year

Canesten 100mg daily PV x at least 1/52 or Fluconazole 150mg po Q72hr x 3 doses

Rx

Canesten 100mg PV daily x 10-14/52 Then Fluconazole 150mg po Q1wk x 6/12

Reference: Dynamed :FSRH/BASHH clinical guideline on management of vaginal discharge in non-genitourinary medicine setting ( BASHH 2012 Feb):