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Candida - female genital - Management
How should I treat severe vulvovaginal candidiasis?
- Send a vaginal specimen for microscopy and culture.
- Treat:
- Treat with either two doses of oral fluconazole (150 mg) 3 days apart, or, if oral treatment is contraindicated, use two clotrimazole pessaries (500 mg) 3 days apart.
- Choice of antifungal will depend upon a number of factors, including the woman's preference.
- For girls aged between 12 and 16 years, an oral antifungal (fluconazole) is generally preferred over intravaginal treatments. However, intravaginal antifungals may be considered if the girl is sexually active, if she uses tampons, or if there is no other alternative.
- For vulval symptoms, consider using a topical antifungal cream (e.g. clotrimazole or econazole) in addition to an oral or intravaginal antifungal.
- Advise the woman to return if symptoms have not resolved within 7–14 days.
In depth
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