Template:Candidiasis Treatment: Difference between revisions
No edit summary |
No edit summary |
||
| Line 21: | Line 21: | ||
*Treat as for uncomplicated (see above) | *Treat as for uncomplicated (see above) | ||
*Once therapy completed, prescribe long-term treatment | *Once therapy completed, prescribe long-term treatment | ||
**Fluconazole 150mg PO qweek x 6 months, OR | **[[Fluconazole]] 150mg PO qweek x 6 months, OR | ||
**Intravaginal medication, such as clotrimazole 500mg PV qweek or 200mg PV twice a week | **Intravaginal medication, such as clotrimazole 500mg PV qweek or 200mg PV twice a week | ||
Revision as of 21:47, 19 June 2024
Uncomplicated
Little resistance azole medications; treatment often dictated by patient preference.
- Fluconazole 150mg PO once (preferred)
- A second dose at 72hrs may be given if patient is still symptomatic
- Intravaginal therapy
- Clotrimazole 1 % cream applied vaginally for 7 days OR
- Clotrimazole 2% applied vaginally for 3 days
- Miconazole 2% cream applied vaginally for 7 days OR 4% cream x 3 days
- Butoconazole 2% applied vaginally x 3 days
- Tioconazole 6.5% applied vaginally x 1
Complicated
Severe or immunosuppressed
- Fluconazole 150mg PO q72h x 3 doses
Non-albicans species For example, C. glabrata, C. krusei and other atypical Candida spp.
- Boric acid vaginal suppository intravaginal qday x ≥14 days
Recurrent (≥ 4 infections in a year)
- Treat as for uncomplicated (see above)
- Once therapy completed, prescribe long-term treatment
- Fluconazole 150mg PO qweek x 6 months, OR
- Intravaginal medication, such as clotrimazole 500mg PV qweek or 200mg PV twice a week
Pregnant Patients
- Intravaginal Clotrimazole or Miconazole are the only recommended treatments
- Duration is 7 days
- PO fluconazole associated with congenital malformations and spontaneous abortions[1]
- ↑ Molgaard-Nielsen D et al. Association Between Use of Oral Fluconazole During Pregnancy and Risk of Spontaneous Abortion and Stillbirth. JAMA. 2016;315(1):58-67.