What medicine to take for fungal vaginitis

True vaginitis is a relatively common disease. It usually causes patients to feel uncomfortable and very painful because of the itchiness and inability to scratch. In addition, patients usually have to wear formal clothes for work, and formal clothes need to be slim-fitting. They cannot wear loose and casual clothes. At this time, everyone just hopes to cure these inflammations quickly. What medicine should be taken for fungal vaginitis?

Treatment

Remove the trigger

Stop using antibiotics and estrogen, and actively treat diabetes.

Topical medications

Select one of the following:

1. Miconazole soft capsule 1200 mg, single dose.

2. Miconazole suppository/soft capsule 400 mg, once every night for 3 days.

3. Miconazole suppository 200 mg, once every night for 7 days.

4. Clotrimazole suppository/tablet 500 mg, single dose.

5. Take clotrimazole suppository 100 mg once every night for 7 days.

6. Take 100,000 U of nystatin effervescent tablets once every night for 14 days.

7. Take 500,000 U of nystatin tablets once every night for 14 days.

Systemic medication

It is suitable for unmarried women without sex life, those who are inconvenient to apply local medication when going out, and those who are about to have their menstrual period. Fluconazole 150 mg, taken once.

Pathological etiology

80-90% of VVC is caused by Candida albicans, and a small number of VVC can be caused by Candida glabrata, Candida parapsilosis or Candida tropicalis. Candida albicans are oval, single-walled cells distributed in groups, with blastospores and pseudohyphae formed by cell germination and elongation. Candida is not heat-resistant and will die if heated to 60℃ for one hour, but it is highly resistant to dryness, sunlight, ultraviolet rays and chemical agents.

About 10% of non-pregnant women and 30% of pregnant women have vaginal Candida parasites without symptoms. When the glycogen in the vagina increases and the pH value decreases, Candida albicans can easily multiply and cause inflammation, so it is more common in pregnant women, diabetic patients and those who use estrogen; after large-scale long-term use of antibiotics, the normal flora in the vagina is suppressed and Candida albicans overgrows; long-term use of immunosuppressants or glucocorticoids can reduce the patient's immune function. These factors can promote vaginal infection and lead to VVC.

Disease diagnosis

The diagnosis of typical VVC is not difficult, but it is easy to be confused with other vulvar lesions, so pathogen examination is required for confirmation. The diagnosis can be made by directly doing a vaginal smear test.

a. Use the 10% KOH hanging drop method to find spores and pseudohyphae under a microscope, and the positive rate can reach 60%.

b. Using Gram staining, the positive rate can reach 80%.

c. The culture method has a higher positive rate and can determine sensitive antifungal drugs, but it takes some time to confirm the diagnosis. It can be used for refractory VVC or recurrent VVC.

d. For stubborn cases, we should actively investigate whether there is a history of estrogen or antibiotic use, and check blood sugar to exclude diabetes.