From the Guidelines
The treatment of vulvovaginitis depends on the underlying cause, but for bacterial vaginosis, metronidazole 500mg orally twice daily for 7 days or clindamycin 300mg orally twice daily for 7 days is recommended 1.
Treatment Options
- For vulvovaginal candidiasis, fluconazole 150mg orally as a single dose or itraconazole 200mg orally twice daily for 1 day is effective 1.
- In cases of trichomoniasis, metronidazole 2g orally as a single dose or 500mg orally twice daily for 7 days is the treatment of choice.
- Topical corticosteroids and antihistamines may also be used to alleviate symptoms such as itching and inflammation.
Important Considerations
- Patients should be advised to avoid consuming alcohol during treatment with metronidazole and for 24 hours thereafter 1.
- Clindamycin cream and ovules are oil-based and might weaken latex condoms and diaphragms 1.
- The creams and suppositories in the regimen are oil-based and may weaken latex condoms and diaphragms 1.
- Self-medication with over-the-counter preparations should be advised only for women who have been diagnosed previously with vulvovaginal candidiasis and who have a recurrence of the same symptoms 1.
From the FDA Drug Label
Fluconazole tablets are a prescription medicine used to treat vaginal yeast infections caused by a yeast called Candida. Fluconazole tablet helps stop too much yeast from growing in the vagina so the yeast infection goes away
The treatment for vulvovaginitis caused by a yeast called Candida is fluconazole tablets, which help stop too much yeast from growing in the vagina so the yeast infection goes away 2.
- Key points:
- Fluconazole tablets are a prescription medicine
- Used to treat vaginal yeast infections caused by Candida
- Helps stop too much yeast from growing in the vagina
- Taken by mouth
From the Research
Treatment Options for Vulvovaginitis
The treatment for vulvovaginitis depends on the underlying cause of the infection. The following are some of the treatment options:
- Bacterial vaginosis: The standard treatment is oral metronidazole 500 mg twice daily for 7 days 3, 4, 5, 6. Alternative treatments include metronidazole vaginal gel and clindamycin vaginal cream 5, 6.
- Vulvovaginal candidiasis: Topical azole and oral fluconazole are equally efficacious in the management of uncomplicated vulvovaginal candidiasis 3, 4. For recurrent or complicated infections, a more extensive regimen may be required 3, 4.
- Trichomoniasis: The standard treatment is a single 2-g oral dose of metronidazole 3, 4, 7. Partner treatment, even without screening, enhances cure rates 4.
Considerations for Treatment
The following are some considerations for treatment:
- Recurrent vulvovaginal candidiasis: Maintenance of weekly oral fluconazole for up to 6 months may be necessary to enhance treatment success 4.
- Trichomoniasis in pregnancy: Treatment with oral metronidazole is warranted to prevent preterm birth 4.
- Bacterial vaginosis in pregnancy: Treatment should focus on the elimination of symptoms, but data on adverse pregnancy outcomes are insufficient to recommend treatment of asymptomatic patients 6.