Version June 2024
Treatment of complicated vulvovaginal candidiasis varies by patient population; there is no single approach.
For patients with recurrent infection, laboratory testing to identify species is critical as non-albicans species require a different treatment approach (refer to UpToDate algorithm addressing vulvovaginitis from non-albicans species).VVC: vulvovaginal candidiasis; BV: bacterial vaginosis.
* Non-albicans species most commonly include C. glabrata and C. krusei. Patients with a history of fluconazole-resistant organisms additionally undergo drug-resistance testing. Patients with non-albicans species (or drug-resistant organisms) require a different treatment approach. (Refer to related text in UpToDate.)
¶ Discussion of testing options to confirm VVC and/or other causes of symptoms are presented in related UpToDate content on abnormal vaginal discharge.
Δ While oral fluconazole is generally the preferred treatment for non-pregnant patients, other treatments are available. Detailed discussions are presented in related UpToDate content on initial treatment of VVC.
◊ Altnerate treatment options include topical azole drugs for 7 to 14 days or ibrexafungerp. Use is discussed in related text in UpToDate on treatment of complicated VVC.
§ Ibrexafungerp is a triterpenoid antifungal (ie, not an azole). Desensitization therapy for fluconazole allergy has not been studied. Oteseconazole is an azole drug and not appropriate for use.
¥ Oteseconazole can also be used as a maintenance drug after oral fluconazole induction treatment. Dosing is discussed in related UpToDate text and Lexicomp drug information.
‡ Some patients may reasonably continue maintenance therapy for a year or more depending on prior frequency of infection and symptom burden.آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟
