From the Guidelines
The recommended treatment for vaginal fungal infections is typically an antifungal medication, with options including over-the-counter topical azole medications like clotrimazole, miconazole, or tioconazole, or a single oral dose of fluconazole 150mg, as outlined in the 2021 Centers for Disease Control and Prevention guidelines 1.
Treatment Options
- Over-the-counter topical azole medications:
- 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
- Tioconazole 6.5% ointment: 5 g intravaginally in a single application
- Prescription intravaginal agents:
- Butoconazole 2% cream: 5 g intravaginally in a single application
- Terconazole 0.4% cream: 5 g intravaginally daily for 7 days
- Terconazole 0.8% cream: 5 g intravaginally daily for 3 days
- Oral agent:
- Fluconazole 150 mg: single dose
Considerations
- For recurrent or complicated infections, longer treatment courses may be needed, such as fluconazole 150mg every 72 hours for 3 doses, or extended topical therapy for 7-14 days 1.
- During treatment, avoid douching, scented products in the genital area, and tight-fitting synthetic underwear.
- Sexual partners generally don't need treatment unless they show symptoms.
- These medications work by disrupting the fungal cell membrane, preventing the yeast (usually Candida albicans) from growing and reproducing.
- Most women experience symptom relief within 2-3 days, though complete treatment should be finished as directed to prevent recurrence.
From the FDA Drug Label
Fluconazole tablets are a prescription medicine used to treat vaginal yeast infections caused by a yeast called Candida. Fluconazole tablet helps stop too much yeast from growing in the vagina so the yeast infection goes away
- The recommended treatment for vaginal fungal infections is fluconazole tablets.
- Fluconazole is a prescription medicine used to treat vaginal yeast infections caused by Candida.
- The treatment helps stop the growth of too much yeast in the vagina, allowing the yeast infection to go away 2.
- Another option is miconazole, a vaginal antifungal available in a combination pack with a vaginal insert and external cream for itch relief 3.
From the Research
Treatment Options for Vaginal Fungal Infections
- Local treatment is often the first line of choice for acute vaginal yeast infections, with a success rate of 84-90% 4
- Antifungal medications such as miconazole, clotrimazole, and fluconazole are commonly used to treat vaginal fungal infections 5, 4, 6
- Oral fluconazole is an effective treatment for vaginal candidosis, with cure rates of over 80% 5
- Maintenance prophylactic treatment with miconazole pessaries can be an effective method of preventing recurrent episodes of vaginal candidosis 7
Recommended Treatment Regimens
- For uncomplicated vulvovaginal candidosis, azoles and short-term regimens are usually recommended for local treatment 6
- Fluconazole is an oral drug of choice for continuous treatment of vaginal yeast infection, with the least toxicity 4
- In cases of recurrent or resistant infections, prolonged local and/or systemic therapy for a period of at least 6 months may be necessary 4
Considerations for Treatment
- The choice of treatment should take into account factors such as pregnancy, menopause, drug hypersensitivity, and women's preferences 6
- The availability, particularities, and cost of antifungal formulations should also be considered when selecting a treatment option 6
- In cases where patients do not respond to initial treatment, the diagnosis should be reconsidered, and other potential causes should be considered 8