From the Guidelines
The recommended treatment for vaginal candidiasis is a short course of topical azoles, such as clotrimazole 1% cream applied intravaginally for 7 days, or single-dose oral fluconazole 150 mg. For uncomplicated cases, first-line treatment options include:
- Clotrimazole 1% cream applied intravaginally for 7-14 days 1
- Miconazole 2% cream applied intravaginally for 7 days 1
- Single-dose oral fluconazole 150 mg 1 These medications work by disrupting the fungal cell membrane, preventing the yeast from growing and reproducing. For severe or complicated infections, a longer course may be needed, such as fluconazole 150 mg taken orally every 72 hours for 2-3 doses, or 7-14 days of topical therapy. During treatment, patients should avoid douching, use cotton underwear, and may benefit from avoiding tight clothing. Sexual partners generally don't require treatment unless they have symptoms. Most cases resolve within 1-2 weeks of treatment, though recurrent infections may require maintenance therapy with weekly fluconazole 150 mg for 6 months in some cases 1. It's essential to note that the treatment of vaginal candidiasis should be based on the severity of the infection and the patient's medical history, and that the most recent and highest quality study should be prioritized when making treatment decisions 1.
From the FDA Drug Label
Dosage and Administration in Adults: Single Dose Vaginal candidiasis: The recommended dosage of fluconazole tablets for vaginal candidiasis is 150 mg as a single oral dose. The recommended treatment for vaginal candidiasis is a single oral dose of 150 mg fluconazole 2.
- Key points:
- The dosage is the same for oral administration.
- Treatment should be continued until clinical parameters or laboratory tests indicate that active fungal infection has subsided.
- Clinical evidence:
- Two adequate and well-controlled studies were conducted in the U.S. using the 150 mg tablet, with results comparable to the control regimen (clotrimazole or miconazole intravaginally for 7 days) both clinically and statistically at the one month post-treatment evaluation 2.
- The therapeutic cure rate was 55% in both the fluconazole group and the vaginal products group.
From the Research
Tratamiento de Candidiasis Vaginal
La candidiasis vaginal es una infección común que afecta a muchas mujeres en todo el mundo. A continuación, se presentan las opciones de tratamiento recomendadas:
- Tratamiento tópico: el tratamiento tópico es el primer línea de elección para el tratamiento de la candidiasis vaginal aguda, con una tasa de éxito del 84-90% 3. Los medicamentos tópicos disponibles incluyen clotrimazol, miconazol, nistatina y others.
- Tratamiento oral: el tratamiento oral con fluconazol es una opción efectiva para el tratamiento de la candidiasis vaginal, especialmente para pacientes con infecciones recurrentes o resistentes 4, 5, 3. La dosis recomendada es de 150 mg en una sola dosis.
- Otras opciones: también se pueden considerar otras opciones de tratamiento, como la itraconazol y la nistatina, aunque su eficacia puede variar dependiendo de la situación específica del paciente 6, 7.
Consideraciones importantes
Al elegir un tratamiento para la candidiasis vaginal, es importante considerar factores como la gravedad de la infección, la historia de infecciones recurrentes, las preferencias del paciente y la disponibilidad de medicamentos 4, 6. Es fundamental seguir las instrucciones del médico y completar el tratamiento para asegurarse de que la infección se cure completamente.