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Infection

Vaginitis

NEW MONOGRAPHS

Possible therapeutic alternatives
Vulvovaginal candidiasis: Candida sp.
Oral alternatives:
Fluconazole 150mg orally as a one-time dose or   Itraconazole 200mg orally twice daily for 2 doses.  
Topical alternatives:   

butoconazole (Femstat):insert one applicatorful intravaginally at bedtime x 3-6 days [2% cream 28g]   
  
Clotrimazole (mycelex, Gyne-Lotrimin): 1 applicatorful at bedtime for 7 days. //Alternatively, 1 vaginal tab (100mg) intravaginally at bedtime for 7 days or 1 (500mg) vaginal tab x 1. [ supplied: 100, 500mg tablets, 1% vaginal cream-45 & 90 grams]   

Miconazole (Monistat)   1 applicatorful intravaginally at bedtime for 7 days. Alternatively, Insert one 200mg vaginal suppository at bedtime for 3 days. 
 
Terconazole (Terazol):  1 applicatorful (0.4%) intravaginally at bedtime for 7 days or (0.8%) at bedtime for 3 days. Alternatively, 80mg vaginal suppository at bedtime for 3 days.

Trichomoniasis (malodorous yellow-green discharge) Trichomonas vaginalis
Flagyl 2 grams orally as single dose or Tinidazole 2 grams orally x 1 or  Flagyl 500mg orally twice daily for 7 days. 
Treatment failures:
retreat with Flagyl 500mg orally twice daily for 7 days. 
Treat sex partners with Flagyl 2 grams x 1 or 500mg orally twice daily for 7 days
Bacterial vaginosis
( Malodorous  vaginal discharge. Over half of the cases are asymptomatic.)
Common pathogens
Flagyl 500mg orally twice daily for 7 days or 
Metrogel:  1 applicatorful intravaginally once daily at bedtime or twice daily (morning and evening) for 5 days. [70g tube 0.75% gel]    or
Clindamycin 300mg orally twice daily for 7 days  or
clindamycin  2% vaginal cream 5 grams intravaginally at bedtime for 7 days.

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References - Infectious Disease Section

Infectious Disease References

Disclaimer

The authors make no claims of the accuracy of the information contained herein; and these suggested doses are not a substitute for clinical judgement. Neither GlobalRPh Inc. nor any other party involved in the preparation of this program shall be liable for any special, consequential, or exemplary damages resulting in whole or part from any user's use of or reliance upon this material.
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