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Candida - female genital - Management
What long courses of antifungals are recommended?
- Oral antifungals:
- Fluconazole 100 mg once a day for 7 days.
- Itraconazole 200 mg once a day for 7 days.
- Intravaginal antifungals:
- Intravaginal pessaries. See Table 1 for more details.
- Intravaginal miconazole 2% cream:
- Insert 5 g into the vagina twice a day for 7 days.
- Insert 5 g into the vagina once a day for 14 days.
Table 1. Long courses of intravaginal pessaries recommended for vulvovaginal candidiasis.
Preparation | Directions |
|---|
Clotrimazole 200 mg* | Insert into the vagina once a night for 6 nights. |
Clotrimazole 100 mg* | Insert into the vagina once a night for 12 nights. |
Econazole 150 mg* | Insert into the vagina once a night for 6 nights. |
* Off licence use |
Basis for recommendation
- These recommendations are based on published expert opinion [CDC, 2006; FFPRHC and BASHH, 2006].
- The doses CKS has recommended for extended courses are guides, as published reviews and guidelines do not give details of what doses to use. Where possible CKS has recommend preparations that are licensed for extended use.
- Nystatin intravaginal cream (Nystan®) is no longer available in the UK.
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