Vulvovaginal candidiasis (VVC) presents with symptoms of itching, redness and discharge. Recurrent VVC (RVVC) is diagnosed when women have ≥4 episodes of VVC within 12 months.
Note: Sensitivity of microscopy is only 50% to 70% and many cases will go undetected | False negative work-up more likely if patient has self-treated with OTC medications | Newer FDA approved commercial tests have higher sensitivities and “may prove to be useful”
Classify as uncomplicated or complicated
VVC is a common clinical condition with most infections due to C. albicans. Uncomplicated infections respond promptly to 1-,3- and 7- day treatment options (see below). Complicated/recurrent VVC may require longer duration of treatment and higher doses of medication. NAC subtypes may be resistant to typical treatment.
Uncomplicated
Complicated
Recurrence (Candida albicans)
Severe Infection (erosions, fissures, edema)
If NAC confirmed
Pregnancy
Note: The CDC states “Epidemiologic studies indicate a single 150-mg dose of fluconazole might be associated with spontaneous abortion and congenital anomalies; therefore, it should not be used”
Other treatments
ACOG Practice Bulletin 215: Vaginitis in Nonpregnant Patients
An Update on the Roles of Non-albicans Candida Species in Vulvovaginitis
BMJ Clinical Evidence: Candidiasis (vulvovaginal)
CDC STI Treatment Guidelines 2021: Vulvovaginal Candidiasis
BMJ: Recurrent vulvovaginal candidiasis
Are you an
ObG Insider?
Get specially curated clinical summaries delivered to your inbox every week for free
Please log in to ObGFirst to access this page
OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.
The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
It appears you don't have enough CME Hours to take this Post-Test. We no longer offer Hours.
You are now leaving the ObG website and on your way to PRIORITY at UCSF, an independent website. Therefore, we are not responsible for the content or availability of this site