A woman presents with a thick curdy-white vaginal discharge. The best treatment for her is:
1.Miconazole
2.Metronidazole
3.Nystatin
4.Doxycycline
View explanation
Thick curdy discharge indicates the causative white organism is candida which is treated by Azole group of antifungals e.g. Fluconazole/Miconazole given orally or applied topically.
Management of Vulvovaginal Candidiasis in Pregnancy:
1st trimester : Nystatin vaginal tablets
2nd trimester : Topical azole antifungal
Management of Recurrent Vulvovaginal Candidiasis:
Recurrent vulvovaginal candidiasis is defined as four or more episodes of vulvovaginal candidiasis in a year. It might be caused by Candida tropicalis or Candida glabrata.
Antibiotic treatment needs to be prolonged (Fluconazole 150 mg weekly x 6 months or ketoconazole/Itraconazole 100 mg daily x 6 months).
Simultaneous treatment of male partner.
Patients on prolonged therapy should have their LFT monitored.