Patient's question:
Medical history and treatment outcomes: I have had excessive vaginal discharge, sometimes clear and sometimes white. I went to the hospital for a bacterial culture, and the result was Candida albicans. However, the doctor said it didn't need treatment and that I could still have children. I, however, doubted her words. I searched online and found that Candida albicans is a type of yeast and needs treatment. This hospital is the best in the city, and the doctor is a chief physician. I don't know what to do now?Doctor's answer:
Hello: Treatment:a. Eliminate the cause
If diabetes is present, active treatment should be provided; broad-spectrum antibiotics and estrogens should be discontinued promptly. Change underwear frequently. Wash used underwear, basins, and towels with boiling water.
b. Change the vaginal pH
Rinse the vagina with a 2%–4% sodium bicarbonate solution to create conditions unfavorable for the survival of Candida.
c. Antifungal agents
After rinsing with an alkaline solution, the following medications can be used:
c1: Clotrimazole (clotrimazole) suppositories or tablets, once daily, 1 suppository or tablet each time, inserted deep into the vagina, for 7 days;
c2: Miconazole nitrate (Daktarin) suppositories, 1 suppository inserted into the vagina each night, for 7 days;
c3: Nystatin (nystatin) suppositories or tablets, once daily, 1 suppository or tablet each time (100,000 U), for 7–10 days;
c4: Miconazole vaginal effervescent tablets, 1 tablet inserted into the vagina each night, for 5 days;
c5: 1% Gentian violet solution for vaginal application, 3–4 times per week, for 2 weeks. The drug is inexpensive and highly effective, but the concentration must be carefully controlled. If the drug is too concentrated or used too frequently, it may cause chemical vulvitis and epidermal erosion. Due to its tendency to stain clothing, it is now rarely used in clinical practice.
d. Treatment for refractory cases
① This condition is often associated with diabetes. If it does not improve with treatment, blood glucose and urine glucose tests should be performed.
② It may also be complicated by trichomoniasis, so a check for Trichomonas vaginalis infection is necessary.
③ To prevent mutual infection of intestinal Candida, nystatin (500,000–1,000,000 U) can be taken orally three times daily, with a course of 7–10 days, to eliminate