From the Guidelines
Vulvovaginal candidiasis can be effectively managed with proper education and treatment, and patients should be advised to use over-the-counter antifungal medications like miconazole, clotrimazole, or tioconazole for mild to moderate infections, as recommended by the 2021 Centers for Disease Control and Prevention guidelines 1.
Patient Education
When educating patients about vulvovaginal candidiasis, it is essential to emphasize the importance of:
- Completing the full treatment course, even if symptoms resolve early
- Avoiding douching, scented feminine products, and tight-fitting synthetic underwear
- Wearing cotton underwear and avoiding prolonged wet clothing
- Wiping from front to back after using the bathroom
- Considering reducing sugar intake, as yeast feeds on sugar
Treatment Options
For mild to moderate infections, the following treatment options are recommended:
- Over-the-counter intravaginal agents, such as:
- Clotrimazole 1% cream, 5 g intravaginally daily for 7-14 days
- Clotrimazole 2% cream, 5 g intravaginally daily for 3 days
- Miconazole 2% cream, 5 g intravaginally daily for 7 days
- Miconazole 4% cream, 5 g intravaginally daily for 3 days
- Prescription oral fluconazole 150mg as a single dose may be recommended for severe or recurrent infections 1
Recurring Infections
For recurring vulvovaginal candidiasis, 10-14 days of induction therapy with a topical agent or oral fluconazole, followed by fluconazole 150mg weekly for 6 months, is recommended 1
Diagnosis
Diagnosis of vulvovaginal candidiasis can be made using microscopy, clinical suspicion, or culture, but molecular testing, such as polymerase chain reaction (PCR), has been shown to have high clinical accuracy and may be a useful diagnostic tool 1
From the FDA Drug Label
Directions before using this product read the enclosed educational brochure for complete directions and information
- Patient Education: The drug label instructs patients to read the enclosed educational brochure for complete directions and information on using clotrimazole for vulvovaginal candidiasis.
- Key Points:
- Adults and children 12 years of age and over should follow the directions in the brochure for using the vaginal cream and external cream.
- Children under 12 years of age should ask a doctor for guidance. The patient should follow the instructions in the educational brochure for complete information on using clotrimazole for vulvovaginal candidiasis 2
From the Research
Patient Education on Vulvovaginal Candidiasis
- Vulvovaginal candidiasis (VVC) is a common disease that affects women worldwide, causing discomfort and requiring effective treatment strategies 3, 4, 5.
- The most common symptoms of VVC include itching, burning, and redness, with similar rankings among patients with VVC and recurrent VVC (RVVC) 6.
- Risk factors for VVC include antibiotic use, intercourse, humid weather, and the use of feminine hygiene products, although many patients report idiopathic episodes with no known cause 6.
Treatment Options for Vulvovaginal Candidiasis
- Topical and oral azoles are the drugs of choice for treating uncomplicated VVC, with clotrimazole being a widely used and effective treatment option 3, 4, 5.
- Other treatment options include oteseconazole, ibrexafungerp, and voriconazole, which may be used in cases of azole intolerance or resistance 4, 5.
- Non-pharmacological interventions, such as probiotics and Redcore lotion, have also shown promise in reducing the risk of VVC recurrence 5.
Patient Management and Outcomes
- Physician-diagnosed and treated cases of VVC tend to have higher levels of symptom relief compared to self-medicated cases 6.
- Patients with RVVC often require continual or long-term antifungal medication as maintenance therapy to control symptoms 6.
- Education on VVC treatment options, risk factors, and symptom management is essential for effective patient care and outcomes 3, 4, 5, 7, 6.