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Recommendations

≥ 18 years
Дозування Ремарки
1st choice
clotrimazole suppository 200 mg once daily for 3 days
2nd choice
clotrimazole topical 5 g once daily for 3 days

or

clotrimazole topical 5 g once daily for 6 days

SWAB remarks

cream 20 mg/g for 3 days, or cream 10 mg/g for 6 days

2nd choice
fluconazole oral 150 mg single dose

Comments

Clotrimazole vaginal tablet or cream: insert deeply into the vagina in the evening at bedtime. One applicatorful of cream is approximately 5 g.

For external itching, also prescribe a topical cream for external use if needed:
- miconazole cream (20 mg/g): apply thinly twice daily until symptoms resolve; or:
- clotrimazole cream (10 mg/g): apply thinly twice daily until symptoms resolve.

Severe vulvovaginal candidiasis requires a longer treatment course (7-14 days):
- clotrimazole cream for vaginal use (10 mg/g), insert 1 applicatorful (5 g) deeply into the vagina at bedtime.
- treat the vulva as well: clotrimazole cream (10 mg/g), or miconazole cream (20 mg/g): apply thinly twice daily.

- In severe candidiasis, treatment may also be with two doses of oral fluconazole 150 mg capsules: 1 capsule on day 1 and 1 capsule on day 4.

Recurrent vulvovaginal candidiasis (>3 episodes/year)
- 1st choice: on-demand treatment: fluconazole 150 mg orally.
- 2nd choice: prophylactic treatment: fluconazole 150 mg capsule, on day 5 of the menstrual cycle for 3-6 months. If insufficiently effective, it may be given up to once weekly.