GYN Candidiasis, PID

Question 1

What is the Mx of candidiasis

Answer 1

Most women - clotrimazole pessary/cream
or oral itaconazole/fluconazole
can combine if severe
YOUNG girls- topical clotrimazole, not intrvaginal or oral)
PREGNANT  -only use intravaginal

Question 2

Advice for candiasis (on top of mx)

Answer 2

Return if not resolving within 14d
Avoid predisposing- 
no washing vulva with soap
cleanign too often
damp and tight pans
vaginal douching

give soap subsititures, and moisturize

Question 3

mx of PID

Answer 3

Consider removal of IUD in situ (if Abx fail to respond after 72)

Abx- Ceftriaxone IM, doxy 14d, metrodinazole 14d

if fail - IV cefoxin +doxy

STI screen - should offer
and give contact azitrhomicin 1dose

+ follow up in 72h for repsonse (if non - IV)
then follow after 2w for ensure resoltion of PID and STI
give contraception etc