Vaginal thrush

Use primarily for treatment of patients with progressive and potentially fatal fungal infections. Do not use to treat noninvasive forms of fungal disease such as oral thrush, vaginal candidiasis, and esophageal candidiasis in patients with normal neutrophil counts. 

Nystatin is active against most Candida sp and is most commonly used for suppression of local candidal infections. Some common indications include oropharyngeal thrush, vaginal candidiasis, and intertriginous candidal infections. 

Systemic histoplasmosis, blastomycosis, coccidiomycosis (includino meningitis), or sporotrichosis. Opportunistic cryptococcosis, candidiasis. Candidal thrush, vaginitis, esophagitis. 

Q85 The patient develops vaginal thrush superinfection. The most appropriate treatment is ... 

The use of imidazole antifungal agents such as econazole is the mainstay of treatment in vaginal thrush (candidiasis). 

Nystatin (Mycostatin) is a polyene antifungal drug with a ring structure similar to that of amphotericin B and a mechanism of action identical to that of amphotericin B. Too toxic for systemic use, nystatin is limited to the topical treatment of superficial infections caused by C albicans. Infections commonly treated by this drug include oral candidiasis (thrush), mild esophageal candidiasis, and vaginitis. 

Fluconazole is very effective in the treatment of infections with most Candida spp. Thrush in the end-stage AIDS patient, often refractory to nystatin, clotrimazole, and ketoconazole, can usually be suppressed with oral fluconazole. AIDS patients with esophageal candidiasis also usually respond to fluconazole. A single 150-mg dose has been shown to be effective treatment for vaginal candidiasis. A 3-day course of oral fluconazole is effective treatment for Candida urinary tract infection and is more convenient than amphotericin B bladder irrigation. Preliminary findings suggest that Candida endophthalmitis can be successfully treated with fluconazole. Stable nonneutropenic patients with candidemia can be adequately treated with fluconazole, but unstable, immunosuppressed patients should initially receive... 

Candida albicans, a yeast, and Trichomonas vagi-nalisis, a protozoa, can cause numerous health problems including vaginal infections, diaper rash, and thrush. The results below show that silver compositions of the present invention produced nearly a 100% kill of both organisms. The results show the utility of silver compositions of the present invention in a feminine hygiene product and in a diaper rash product. 

B. Azole antifungals include systemic agents such as keto-conazole, fluconazole, itraconazole, and voriconazole. Topical agents used for the treatment of vaginal candidiasis and thrush include miconazole and clotrimazole. The pharmacologic properties of the systemic azoles differ considerably. Ketoconazole, the first oral azole developed, has poor bioavailability and requires an acidic environment for enhanced absorption. Thus, initial studies required ketoconazole to be administered with a cola to increase bioavailability. Fluconazole, unlike itraconazole and ketoconazole, is hydrophillic and has increased penetration across the blood-brain barrier. Fluconazole is also the only azole that is renally eliminated. 

Vaginal thrush (vulvovaginal candidiasis) is caused by a yeast, Candida albicans, a usually harmless inhabitant of the gastrointestinal tract, skin and vagina, which overgrows to cause infections when conditions allow. 

Cystitis with thrush, discomfort when urinating may be confused with dysuria associated with cystitis. However, in thrush the discomfort and burning are in the external vaginal area rather than in the bladder and urethra, as in cystitis. 

Atrophic vaginitis in postmenopausal women lack of oestrogen reduces vaginal resistance to infection and injury, which can produce similar burning and itching symptoms to thrush, but thrush is uncommon in postmenopausal women. 

If vaginal candidiasis has not been previously diagnosed by a doctor. There are other vaginal infections, some serious and all requiring treatment with prescription-only medication, with symptoms that could be confused with thrush. An initial medical diagnosis of candidiasis is necessary so that sufferers can recognise the condition subsequently. 

Most treatments for vaginal thrush are available without prescription. 

Azoles available without prescription for treatment of vaginal thrush are fluconazole, clotrimazole and econazole. 

Assuming that there were no other factors preventing supply, to which of the following could a fluconazole 150 mg capsule for the treatment of vaginal thrush not be sold ... 

Tea tree oil, obtained from Melaleuca altemifolia, has been shown to be highly active against Candida albicans, which causes thrush in infants and other diseases, and, in addition, excellent control of vaginitis caused by the same organism. Bacterial impetigo, caused by Staphylococcus aureus and Streptococcus sp. has also been treated successfully. The constitution of the oil has been analyzed and it contains 1,8-cineole 9.1%, p-cymene 16.4%, terpinen-4-ol 31.2% and a-terpineol 3.5% (Figure 1 [4,5,6,7]). 

Candida most often infects the mouth (thrush) or the vagina, particularly in persons with impaired cell-mediated immunity. Thrush is generally treated with nystatin "swish and swallow," and vaginitis is usually treated with miconazole. Systemic Candida infections occur in immunosuppressed patients and requires intravenous amphotericin B. 

The most common cause of yeast infections is Candida albicans, which is part of the normal flora in a significant portion of the population where it resides in the oropharynx, gastrointestinal tract, vagina, and surrounding skin (4). It is the principal cause of vaginal yeast infections and oral yeast infections (thrush). These commonly occur in mucosal tissue when the normal population of flora has been disturbed by treatment of a bacterial infection with an antibiotic or when growth conditions are... 

There is no simple relation between the reclassification of a medicine as an OTC and the level of subsequent prescribing [4] external factors may play the dominant role. When aciclovir cream was delisted for the treatment of cold sores the event coincided with heavy advertising for its use. The pubhcity may have affected the extent of OTC use, but there was tittle change in the volume of prescribing. When on the other hand clotrimazole products for the treatment of vaginal candidiasis (thrush) were released for over the counter sale, the increase in overall use was accompanied by a decline in the prescribing of these products. 

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