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Vaginitis

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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Vaginitis