Patient's question:
Suffering from candidiasis, this is the second time. The doctor prescribed a 3-day course of Sporanox and Daktarin, but after completing the course, the itching still persists. Now I don't know what to do. Going to the hospital means waiting until Saturday. The first time was in April 2009, and this time is in March 2010. The reason is unclear.Doctor's answer:
Disease Analysis:1) General Treatment: Actively treat other diseases that can cause candidal vulvovaginitis and eliminate predisposing factors. Maintain external genital hygiene and dryness, and avoid scratching. Abstain from sexual activity during treatment. Avoid spicy and irritating foods.
2) Changing Vaginal pH: The optimal pH for Candida growth is 5.5. Therefore, using alkaline solutions to rinse the external genitalia and vagina can alter the vaginal pH, inhibiting the growth and reproduction of Candida. A 2%–4% baking soda solution can be used to rinse the vagina once or twice daily, with 2 weeks constituting one course. After rinsing, dry the external genitalia to maintain dryness and inhibit Candida growth.
Guidance:
3) Vaginal Medication: Using imidazole suppositories for vaginal medication is highly effective for candidal vulvovaginitis. Clotrimazole suppositories: 1 suppository nightly, inserted into the vagina after rinsing, with 10–14 days constituting one course. Alternatively, Daktarin suppositories: 1 suppository nightly, inserted into the vagina after rinsing, with 7 days constituting one course.
4) Topical Creams: Applying clotrimazole cream or Daktarin cream externally can treat vulvitis caused by Candida infection and alleviate symptoms such as itching and pain. Apply externally several times daily for 2 weeks. Eucerin cream, containing econazole as the active ingredient and a small amount of topical steroid, provides good anti-itch effects and is particularly suitable for those with Candida vulvovaginitis and severe external genital itching and pain. Apply externally twice daily, morning and evening.
5) Oral Medication: Since Candida infection can be transmitted between partners through sexual activity, oral medication can be used to treat both individuals. Oral medication can also inhibit intestinal Candida. Fluconazole oral: 150 mg once daily. Alternatively, Sporanox oral: For primary Candida vulvovaginitis, take 200 mg once in the morning and evening, for only 1 day. For recurrent candidal vulvovaginitis, increase the dose of Sporanox: 200 mg once daily for 3 days, or 100 mg twice daily for 3 days. All medications should be taken after meals.