From the Guidelines
For vulvovaginitis, the cream of choice is Clotrimazole 1% cream applied intravaginally for 7 days, as it is a highly effective option with a high cure rate, according to the most recent and highest quality study 1.
Treatment Options
The treatment of vulvovaginitis depends on the underlying cause, which can be infectious or non-infectious.
- For yeast infections (candidiasis), Clotrimazole 1% cream applied intravaginally for 7 days is a highly effective option, with a cure rate of 80-90% 1.
- Other options include Butoconazole 2% cream, Miconazole 2% cream, and Terconazole 0.4% cream, which can be applied intravaginally for 3-7 days 1.
Important Considerations
- It is essential to complete the full treatment course, even if symptoms improve quickly, to ensure complete eradication of the infection.
- Patients should be advised to avoid sexual intercourse during treatment or use condoms to prevent reinfection or irritation.
- The creams and suppositories used to treat vulvovaginitis are oil-based and may weaken latex condoms and diaphragms, so patients should be aware of this potential interaction 1.
Diagnosis and Follow-Up
- The diagnosis of vulvovaginitis is typically made based on clinical presentation and laboratory tests, such as wet mount and culture.
- Patients should be instructed to return for follow-up visits only if symptoms persist or recur after treatment.
From the FDA Drug Label
1.4 Bacterial Vaginosis Tinidazole is indicated for the treatment of bacterial vaginosis (formerly referred to as vaginitis, vaginitis, nonspecific vaginitis, or anaerobic vaginosis) in adult women Other pathogens commonly associated with vulvovaginitis such as Trichomonas vaginalis, Chlamydia trachomatis, Neisseria gonorrhoeae, Candida albicans and Herpes simplex virus should be ruled out.
The cream of choice for vulvovaginitis is not specified in the provided drug label, as tinidazole is an oral medication, not a cream. The label does indicate that tinidazole is used to treat bacterial vaginosis, a type of vulvovaginitis, but it does not mention a cream formulation. 2
From the Research
Treatment Options for Vulvovaginitis
- Clotrimazole is a commonly used treatment for vulvovaginal candidosis, with high cure rates and effectiveness in both uncomplicated and complicated cases 3, 4.
- Topical and oral antifungal azole medications, such as clotrimazole, are equally effective in treating vulvovaginal candidiasis 5.
- A combination of vaginal treatment and cream for the vulva, such as clotrimazole vaginal suppositories and clotrimazole cream, may be more effective than vaginal treatment alone 6.
Comparison of Treatments
- A study comparing Mycozin and Clotrimazole 1% creams found that Clotrimazole was more effective in reducing itching, but there was no significant difference in other symptoms and signs 7.
- Mycozin vaginal cream may be a suitable alternative for patients interested in herbal medicines and resistant to azole compounds 7.