How should you treat Candida vaginitis in patients on antibiotics?

Abstract

Oral and intravaginal antifungals for the treatment of uncomplicated vulvovaginal candidiasis (VVC) have similar effectiveness (strength of recommendation [SOR]: A, systematic review). However, no randomized controlled trials (RCTs) have addressed treatment options for patients taking antibiotics. Oral antifungals are contra-indicated in pregnancy. While shorter courses of intravaginal therapy can be used by nonpregnant women, 7-day treatment may be necessary during pregnancy (SOR: A, systematic review). Products containing Lactobacillus species do not prevent postantibiotic vulvovaginitis (SOR: A, systematic review and RCT).