From the Guidelines
To prevent yeast infections from recurring after treatment, fluconazole 100 mg taken orally three times weekly is recommended. This maintenance antifungal therapy has been shown to significantly reduce recurrence rates 1. Additionally, lifestyle modifications such as wearing loose-fitting cotton underwear, avoiding douching and scented feminine hygiene products, changing out of wet clothing promptly, and maintaining good hygiene without using harsh soaps in the genital area can help prevent yeast overgrowth. Dietary changes, including reducing sugar and refined carbohydrate intake, can also be beneficial as yeast feeds on these substances. For those with diabetes, maintaining good blood sugar control is essential since elevated glucose levels can promote yeast growth. Some women may also benefit from intermittent use of boric acid suppositories or other topical antifungal agents, but fluconazole remains the first-line choice for maintenance therapy due to its efficacy and convenience 1.
Some key points to consider:
- Maintenance antifungal therapy is crucial for preventing recurrence, especially in patients with a history of recurrent vulvovaginal candidiasis (RVVC) 1.
- Fluconazole is the most commonly recommended medication for maintenance therapy due to its effectiveness and safety profile 1.
- Lifestyle and dietary modifications can complement antifungal therapy by reducing the risk of yeast overgrowth and promoting a healthy vaginal flora.
- New treatments, such as oteseconazole, are being developed and may offer alternative options for patients who do not respond to fluconazole or have recurrent infections despite maintenance therapy 1.
Overall, the goal of prevention is to reduce the frequency and severity of yeast infections, thereby improving quality of life for affected individuals. By combining maintenance antifungal therapy with lifestyle and dietary modifications, patients can effectively manage their condition and prevent recurrence.
From the FDA Drug Label
DIFLUCAN is also indicated to decrease the incidence of candidiasis in patients undergoing bone marrow transplantation who receive cytotoxic chemotherapy and/or radiation therapy. To prevent yeast infections from recurring after treatment, prophylaxis with a medication like DIFLUCAN (fluconazole) can be used in specific cases, such as in patients undergoing bone marrow transplantation who receive cytotoxic chemotherapy and/or radiation therapy 2. However, for general prevention of recurrent yeast infections, the label does not provide direct guidance.
From the Research
Preventing Yeast Infections from Recurring
To prevent yeast infections from recurring after treatment, several options can be considered:
- Topical antifungal agents such as azole drugs (miconazole, clotrimazole, ketoconazole) which are fungistatic, limiting fungal growth but depending on epidermal turnover to shed the still-living fungus from the skin surface 3
- Allylamines and benzylamines (terbinafine, naftifine, butenafine) which are fungicidal, actually killing the fungal organisms 3
- Prophylactic antifungal washes, such as ketoconazole or clotrimazole solution, can be used to minimize the chances of recurrence 4
- Topical therapies like clotrimazole, nystatin, and miconazole have demonstrated similar efficacy with complete cure rates of 73%-100% 5
Choosing the Right Treatment
When choosing a treatment to prevent yeast infections from recurring, consider the following:
- Cost is a factor dictating prescription choice, especially since most products work well regardless of mechanism of action 3
- Patient preference for treatment formulation, such as spray, cream, or lotion 3
- The effectiveness of the treatment in preventing recurrence, with prophylactic antifungal washes showing promising results 4
Additional Considerations
Other factors to consider when preventing yeast infections from recurring include: