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Vulvovaginal candidiasis
Guidelines
Key sources
The following summarized guidelines for the evaluation and management of vulvovaginal candidiasis are prepared by our editorial team based on guidelines from the U.S. Department of Health and Human Services (DHHS 2025), the World Health Organization (WHO 2024), the Center for Disease Control (CDC 2021), the American College of Obstetricians and Gynecologists (ACOG 2020), the International Union Against Sexually Transmitted ...
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Screening and diagnosis
Medical management
Antifungal therapy, agents
As per CDC 2021 guidelines:
Recognize that OTC intravaginal agents for VVC include:
Situation
Guidance
Clotrimazole
1% cream 5 g intravaginally daily for 7-14 days
2% cream 5 g intravaginally daily for 3 days
Miconazole
2% cream 5 g intravaginally daily for 7 days
4% cream 5 g intravaginally daily for 3 days
100 mg vaginal suppository one suppository daily for 7 days
200 mg vaginal suppository one suppository for 3 days
1,200 mg vaginal suppository one suppository for 1 day
Tioconazole
6.5% ointment 5 g intravaginally in a single application
E
Recognize that prescription drugs for VVC include:
Situation
Guidance
Butoconazole
2% cream (single-dose bioadhesive product) 5 g intravaginally in a single application
Terconazole
0.4% cream 5 g intravaginally daily for 7 days
0.8% cream 5 g intravaginally daily for 3 days
80 mg vaginal suppository one suppository daily for 3 days
Fluconazole
150 mg PO in a single dose
E
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Antifungal therapy (uncomplicated disease)
Antifungal therapy (severe disease)
Management of recurrence
Specific circumstances
Pregnant patients: as per WHO 2024 guidelines, consider administering the following option in pregnant patients with VVC:
clotrimazole 100 mg intravaginally once daily for 7 days or 1% cream intravaginally once daily for 7 days
nystatin 100,000 units intravaginally BID for 15 days.
C
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Patients with C. glabrata infection
Patients with HIV (antifungal therapy, uncomplicated disease)
Patients with HIV (secondary prevention)
Patients with HIV (pregnant patients)