Treatment of Vulvovaginal

Candidiasis(Thrush)
•Asymptomatic women do not need treatment
•First line treatment is usually topical for symptomatic women
•Longer courses are recommended – a 4-day course has a 50% cure rate and a 7-day
course cures over 90% of cases
General advice
Good skin care is important. Please advise patients:
• To avoid the use of local irritants such as perfumed soaps or wipes
• To use emollient for personal hygiene as a soap substitute, as a moisturiser and a
barrier cream (patient needs to be informed that this does not constitute “internal
use”).
Recommended regimens:
• Clotrimazole pessary(Canesten) 500mg intravaginally at night for up to 7
consecutive nights
Alternative regimens:
• Clotrimazole vaginal cream (10%) 5g intravaginally at night for up to 7 consecutive
nights
• Clotrimazole pessary 200mg intravaginally at night for up to 7 consecutive nights
• Econazole pessary 150mg intravaginally at night for up to 7 consecutive nights
 Recurrent VVC/Thrush in Pregnancy

Diagnosis
•Four or more episodes of symptomatic candida in 1 year, with at least partial
resolution between episodes.
•Candida confirmed by culture or microscopy on at least two of the occasions.

Recommended regimen
• Induction: Canesten therapy can be increased to 10-14 days according to
symptomatic response.

• Maintenance: Clotrimazole pessary(Canesten) 500mg intravaginally weekly.

Recommended regimens for acute and recurrent VVC in breastfeeding

• Same as for non-pregnant women with acute and recurrent VVC.

*(Please refer to BASHH guideline VVC 2019 for further information)