Fluconazole Dosing for Groin Yeast Infection
For a yeast infection in the groin (tinea cruris or cutaneous candidiasis), prescribe fluconazole 150 mg once weekly for 2-4 weeks, with most patients requiring an average of 2-3 doses total. 1, 2
Dosing Algorithm
For Cutaneous Candidiasis (Groin)
- Start with: Fluconazole 150 mg once weekly 2
- Duration: 2-4 doses (average 2.6 doses in clinical trials) 2
- Candida albicans infections: Typically require only 2 doses 2
- Other Candida species: May require 3-4 doses 2
Clinical Response Expectations
- Clinical cure rate: 92% at final assessment 2
- Long-term cure (28-30 days post-treatment): 88% 2
- Mycological eradication: 99% at final follow-up 2
Important Clinical Considerations
Distinguishing Groin Infections
The term "yeast infection in the groin" requires clarification, as this differs significantly from vulvovaginal candidiasis:
- If this is tinea cruris (jock itch): Most commonly caused by Trichophyton rubrum (67% of cases), not Candida, and requires 3-4 weekly doses of fluconazole 150 mg 2
- If this is cutaneous candidiasis of the groin: Caused by Candida albicans and requires only 2 weekly doses of fluconazole 150 mg 2
- If this is vulvovaginal candidiasis: Single 150 mg dose for uncomplicated cases 3, 1
Relapse Rates by Location
- Tinea corporis: 7% relapse rate 2
- Tinea cruris: 14% relapse rate (higher than other sites) 2
- The higher relapse rate in groin infections justifies the longer treatment duration compared to vaginal candidiasis 2
Practical Prescribing
Write the prescription as: Fluconazole 150 mg tablets, dispense 2-4 tablets, take one tablet by mouth once weekly until infection resolves (typically 2-4 weeks). 2
When to Prescribe More Doses
- 2 doses: For confirmed Candida albicans or Epidermophyton floccosum 2
- 3-4 doses: For Trichophyton species or if clinical response is incomplete after 2 doses 2