Bacterical Vaginal/vaginal Thrush

Question 1

Types

Answer 1

Vulvovaginal candidiasis and bacterial vaginosis

Question 2

Causes

Answer 2

Disturbance on the normal vaginal flora. Reduction in hydrogen peroxide producing lactobacilli and increase in anaerobic gram-negative and other non-commensal bacteria

Question 3

Symptoms

Answer 3

Itch
Soreness
Burning
Redness
Swelling
Thick odourless white discharge.

Question 4

When to refer

Answer 4

first time
recurrent more than 4 a year
not responding to therapy
abnormal vaginal bleeding/irregular menstrual bleeding
younger than 18 older than 60

Question 5

Causes

Answer 5

Trichomoniasis
Atrophic vaginitis
Vulvovaginal dermatitis
Genital herpes
Urinary tract infection
Pelvic inflammatory disease
Cytolytic vaginosis
Lichen sclerosus

Question 6

bacterial vaginosis treatment

Answer 6

Astrodrimer sodium vaginal gel

Question 7

vulvovaginal candidiasis

Answer 7

Pessaries = Clotrimazole, Nystatin
Oral = Fluconazole

Question 8

Clotrimazole

Answer 8

Cream 1% - apply 2-3 times a day to affected external anogenital areas.
Vaginal cream - insert 1 applicator full into vaginal area daily until contents of tubs are all used
Pessary = Insert 1 pessary into the vaginal area until all are used.

Question 9

Clotrimazole pregnancy and breastfeeding

Answer 9

Pregnancy - safe to use (1 week course preferred)
Breastfeeding safe to use.

Question 10

Fluconazole

Answer 10

Use if topical has failed (need to be prescribed)
Uncomplicated - 150mg single dose
Severe - 150mg every 3 days for 6-9 days
Recurrent infection - 150mg every 3 days for 9 days and then 150mg once a week for up to 6 months

Question 11

Questions to ask

Answer 11

Have you have it before?
How often does it occur?
Are you breastfeeding/pregnant?