Vulvovaginal_Candidiasis_Flashcards
What is the first-line antifungal treatment for most women with vulvovaginal candidiasis?
The first-line antifungal treatment for most women with vulvovaginal candidiasis is local clotrimazole pessary or cream (e.g., clotrimazole 500 mg PV stat), which is also first-line in pregnancy.
What antifungal treatments are recommended for non-pregnant women with vulvovaginal candidiasis?
Oral itraconazole 200 mg PO BD for 1 day or fluconazole 150 mg PO stat are recommended for non-pregnant women with vulvovaginal candidiasis.
What antifungal treatment should be considered for girls aged 12-15 years with vulvovaginal candidiasis?
For girls aged 12-15 years, consider prescribing topical clotrimazole 1% or 2% applied 2-3 times per day, but do not prescribe intravaginal or oral antifungal.
What is the recommended antifungal treatment for pregnant women with vulvovaginal candidiasis?
The recommended antifungal treatment for pregnant women with vulvovaginal candidiasis is intravaginal clotrimazole; oral antifungals should not be used.
What should be used if vulval symptoms are present in addition to an oral or intravaginal antifungal?
If vulval symptoms are present, use topical imidazole (clotrimazole, ketoconazole) in addition to an oral or intravaginal antifungal.
What is a potential issue with using topical imidazole?
Topical imidazole can damage latex condoms and diaphragms.
What should patients do if symptoms of vulvovaginal candidiasis have not resolved in 7-14 days?
Patients should return if symptoms have not resolved in 7-14 days.
What are some predisposing factors for vulvovaginal candidiasis that should be avoided?
Predisposing factors that should be avoided include washing and cleaning the vulval area with soap or shower gels, wipes, and feminine hygiene products, cleaning the vulval area more than once per day, washing underwear in biological washing powder and using fabric conditioners, vaginal douching, and wearing tight-fitting and/or non-absorbent clothing.
How should the vulval area be washed to avoid exacerbating vulvovaginal candidiasis symptoms?
The vulval area should be washed with a soap substitute, used externally and not more than once per day.
What are some additional measures that can be taken to relieve symptoms of vulvovaginal candidiasis?
Additional measures to relieve symptoms of vulvovaginal candidiasis include using a simple emollient to moisturise the vulval area and considering probiotics (e.g., live yoghurts) orally or topically.
Should asymptomatic sexual partners be routinely treated for vulvovaginal candidiasis?
Asymptomatic sexual partners should not be routinely treated for vulvovaginal candidiasis.
What are the treatment options for vulvovaginal candidiasis?
The treatment options for vulvovaginal candidiasis include either local or oral treatment. Local treatment includes clotrimazole pessary or cream (e.g., clotrimazole 500 mg PV stat). Oral treatment includes itraconazole 200 mg PO BD for 1 day or fluconazole 150 mg PO stat. In pregnancy, only local treatments should be used.
What are some risk factors for vulvovaginal candidiasis?
Risk factors for vulvovaginal candidiasis include recent antibiotic use, oral contraceptives, diabetes mellitus, and excessive washing.
How should the diagnosis of vulvovaginal candidiasis be explained to patients?
The diagnosis of vulvovaginal candidiasis should be explained as not being an STI/STD.
What hygiene measures should be explained to patients with vulvovaginal candidiasis?
Hygiene measures should be explained to patients, including not cleaning too often, avoiding using fabric conditioners and soap substitutes.
