From the Guidelines
For treating a yeast infection, the most effective treatment is a single 150mg oral fluconazole tablet or an over-the-counter antifungal medication such as clotrimazole or miconazole, used for 1-7 days as directed on the package. The treatment of yeast infections, specifically vulvovaginal candidiasis (VVC), has been extensively studied, and the most recent guidelines recommend the use of azole antifungals, such as fluconazole, as the first-line treatment 1.
Treatment Options
- For vaginal yeast infections, the following treatment options are available:
- Over-the-counter intravaginal agents: 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), and miconazole 4% cream (5 g intravaginally daily for 3 days) 1
- Prescription intravaginal agents: butoconazole 2% cream (single dose bioadhesive product), terconazole 0.4% cream (5 g intravaginally daily for 7 days), and terconazole 0.8% cream (5 g intravaginally daily for 3 days) 1
- Oral agent: fluconazole 150 mg (single dose) 1
- For skin yeast infections, apply antifungal creams like clotrimazole or miconazole 2-3 times daily for 1-2 weeks.
- For oral thrush, use nystatin oral suspension (swish and swallow 4-5 times daily) or clotrimazole lozenges (dissolve in mouth 5 times daily) for 7-14 days.
Important Considerations
It is essential to note that the diagnosis of VVC should be confirmed by a wet-mount preparation with use of saline and 10% potassium hydroxide to demonstrate the presence of yeast or hyphae and a normal pH (4.0–4.5) 1. Additionally, if symptoms persist after a week of treatment, or if you experience recurrent infections, consult a healthcare provider as you may need prescription-strength medication or have an underlying condition requiring attention. The treatment of VVC should not differ on the basis of human immunodeficiency virus (HIV) infection status; identical response rates are anticipated for HIV-positive and HIV-negative women 1.
Recurring Vulvovaginal Candidiasis
For recurring vulvovaginal candidiasis, 10–14 days of induction therapy with a topical agent or oral fluconazole, followed by fluconazole, 150 mg weekly for 6 months, is recommended (strong recommendation; high-quality evidence) 1. This approach has been shown to achieve control of symptoms in >90% of patients 1.
From the FDA Drug Label
The FDA drug label does not answer the question about treatment for yeast. However, the provided drug labels for micafungin and caspofungin mention the treatment of various Candida infections, including candidemia, esophageal candidiasis, and other Candida infections.
- Micafungin is indicated for the treatment of candidemia and other Candida infections, as well as for esophageal candidiasis 2 2.
- Caspofungin is also indicated for the treatment of candidemia and other Candida infections, including intra-abdominal abscesses, peritonitis, and pleural space infections, as well as for esophageal candidiasis 3. However, without more specific information about the type of yeast infection, it is difficult to provide a more detailed answer. It is essential to consult the FDA drug label and other relevant medical resources to determine the appropriate treatment for a specific yeast infection.
From the Research
Treatment Options for Yeast Infections
- Local treatment is the first line of choice in cases of acute vaginal yeast infection, with a success rate of 84-90% 4
- Various local preparations are available, including Nizoral, Clotrimazole, Canesten, Gyno-Daktarine, Gyno-Pevaryl, and Miconazole 4
- Broad-spectrum oral antimycotics, such as Nystatine, Ketoconazole, Fluconazole, and Itraconazole, can also be used 4, 5
- Fluconazole is an oral drug of choice for continuous treatment of vaginal yeast infection, with the least toxicity 4
- For chronic, recurrent, and resistant forms of vaginal candidosis, prolonged local and/or systemic therapy for a period of at least 6 months is recommended 4
Antifungal Medications
- Fluconazole is well established as a first-line management option for the treatment and prophylaxis of localized and systemic C. albicans infections 5
- Itraconazole can be used as a second-line therapy for C. albicans infections that are not responsive to conventional doses of fluconazole 5
- Topical antifungal medications, such as zinc pyrithione, ketoconazole, and terbinafine, are the first-line treatment for Pityriasis Versicolor 6
- Oral antifungal medications, such as itraconazole and fluconazole, may be used in cases of severe or recalcitrant Pityriasis Versicolor 6
Special Considerations
- In immunocompromised patients, such as those with haematological malignancies or undergoing haemopoietic stem cell transplants, antifungal management of established invasive yeast infections is crucial 7
- Consideration should be given to the critically ill patient in intensive care units, including the neonatal intensive care unit 7