From the Guidelines
Oral vancomycin is not effective for treating yeast infections. Vancomycin is an antibiotic that targets bacteria, particularly gram-positive bacteria, and has no activity against fungi like Candida which causes yeast infections. For vaginal yeast infections, appropriate treatments include topical antifungals such as clotrimazole, miconazole, or terconazole creams or suppositories for 1-7 days depending on the formulation. Alternatively, oral fluconazole 150mg as a single dose is effective for uncomplicated cases, as recommended by the Infectious Diseases Society of America 1. For oral thrush (oral candidiasis), nystatin oral suspension, clotrimazole troches, or fluconazole 100-200mg daily for 7-14 days are recommended. The ineffectiveness of vancomycin against yeast is due to its mechanism of action, which inhibits bacterial cell wall synthesis by binding to the D-Ala-D-Ala terminus of peptidoglycan precursors. Fungi have cell walls composed primarily of chitin and glucans rather than peptidoglycan, making them intrinsically resistant to vancomycin. Using inappropriate antimicrobials can delay effective treatment and potentially contribute to antimicrobial resistance.
Some key points to consider when treating yeast infections include:
- The use of azole antifungals as the backbone of treatment for vulvovaginal candidiasis, as stated in the 2021 Centers for Disease Control and Prevention guidelines 1.
- The importance of proper diagnosis, with yeast culture remaining the gold standard for diagnoses 1.
- The potential for newer treatments, such as ibrexafungerp, to be effective in clinical trials 1.
- The need to consider the potential risks and benefits of treatment, particularly in pregnant women or those with HIV infection 1.
It is essential to note that vancomycin is used to treat bacterial infections, such as Clostridioides difficile infection, and its use in treating yeast infections is not supported by the evidence 1. The most recent and highest quality study recommends the use of azole antifungals for the treatment of yeast infections, and vancomycin should not be used as a treatment option 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Yeast Infection Treatment with Oral Vanco
- There is no direct evidence to support the use of oral vancomycin (Vanco) for yeast infections, as vancomycin is an antibiotic used to treat bacterial infections, not fungal infections 2, 3, 4, 5, 6.
Alternative Treatment Options
- Voriconazole, an antifungal agent, has been shown to be effective in treating refractory vulvovaginal yeast infections, including those resistant to fluconazole 5.
- Fluconazole and itraconazole are also used to treat yeast infections, but resistance to these agents has been reported 3, 4.
Important Considerations
- The treatment of yeast infections should be guided by the results of fungal culture and susceptibility testing to ensure the use of effective antifungal agents 4, 5.
- Combination antifungal therapy may be considered in selected patients with invasive fungal infections, but this approach is empiric and driven by individual physician practice 2.