Vaginal Candida: Antifungal Drugs

Currently, on the market, antifungal drugs that can be used in the presence of vaginal candida are present in three formulations:

• In cream ( topical antifungals );
• In tablet for vaginal use ( antifungals for vaginal use );
• In tablet for oral use ( oral antifungals ).

Topical Antifungals
Topical antifungals for the treatment of vaginal candida are drugs in the form of a cream to spread on the genital areas affected by the infection (vulva and vagina).

Among the topical antifungals used in the presence of vaginal candida, clotrimazole , econazole , fenticonazole nitrate , miconazole and nystatin are reported .

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With the exception of nystatin (which is an antibiotic with antifungal action), clotrimazole, econazole, fenticonazole nitrate and miconazole belong to the category of so-called imidazole derivatives (or imidazole derivatives ); imidazole derivatives are antifungal drugs that exert their power by destroying the cell membrane of fungi.

Vaginal antifungals
Vaginal antifungals for the treatment of vaginal candida are drugs in the form of tablets to be inserted into the vagina.

Among the antifungals for vaginal use used in the presence of vaginal candida are the aforementioned clotrimazole, econazole, fenticonazole nitrate, miconazole and nystatin (they are the tablet version for vaginal use of those in cream mentioned above).

Possible side effects of clotrimazole, econazole and fenticonazole nitrate (both for topical and vaginal use): local burning and skin irritation.

Oral Antifungals
Oral antifungals for the treatment of vaginal candida are drugs in tablet form to be ingested by mouth.

Among the oral antifungals used in the presence of vaginal candida, fluconazole and itraconazole stand out .

Fluconazole and itraconazole belong to the category of triazoles ; characterized by a stronger anti-fungal power than imidazole derivatives, triazoles act against some enzymes that fungi like Candida albicans use to reproduce and survive (in simpler words, they destroy molecules essential for the reproduction of fungi).

Possible side effects of fluconazole and itraconazole: nausea , abdominal pain , diarrhea and flatulence .

Attention to Personal Hygiene
Paying attention to personal hygiene is a fundamental step in the treatment of vaginal candida.
In this sense, the rules to be followed include:

Use of good quality intimate cleansers , so as not to irritate the already suffering genital area;
Be careful, after each shower, to dry the genital areas .

 What to do when you get Vaginal Candida for the first time

Women who develop vaginal candida for the first time must undergo a thorough medical examination, which includes, in addition to the observation of the symptoms, also the evaluation of the clinical history.

The information that emerges from the clinical history is of fundamental importance for the understanding of the precise triggers of vaginal candidiasis and for the planning of the most appropriate treatment plan.

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If the doctor has doubts or considers it possible the presence of a serious disease that has not yet been diagnosed (such as diabetes), he will most likely resort to the diagnostic tests already mentioned several times, i.e. blood tests, urine and vaginal swab.

 What to do in case of Recurrent Vaginal Candida

Generally, women who repeatedly suffer from vaginal candida are people at risk (eg: diabetes sufferers), aware of the reason behind the recurrence of the infection.

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When this is not the case, however, they should undergo diagnostic tests, to find out the reason for the repeated episodes of vaginal candida; the diagnostic tests indicated include: blood test, urinalysis and vaginal swab.

 How to recognize vaginal candida?

Generally, for the diagnosis of vaginal candida, an accurate physical examination is sufficient , during which the doctor analyzes the symptomatological picture in detail, and a careful evaluation of the patient's clinical history (or anamnesis ).

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In special situations, however, it may happen that it is necessary to resort also to the execution of laboratory tests , such as the ' analysis of blood , l' examination of urine and vaginal swab .

 Consequences of Vaginal Candidiasis in Pregnancy

In the absence of adequate treatment, vaginal candida in pregnant women is a risk factor for premature birth (or preterm delivery ).

Additionally, in a very small percentage of pregnant women with vaginal candida, the infection can be passed on to the baby at delivery, resulting in a condition known as congenital neonatal candida (or neonatal candida ). 

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Vaginal Candida: when to worry?
The appearance of suspicious symptoms, such as pain and itching in the genitals and pain during urination and during sexual intercourse, should prompt you to contact your general practitioner immediately, who will most likely prescribe a specialist visit to a gynecologist .

 Who is most at risk for Invasive Candidiasis?

Among women with vaginal candida, they are most at risk for invasive candidiasis:

•  People with AIDS. As the reader will recall, AIDS affects the efficiency of the immune defenses;
• Those taking immunosuppressive drugs. This is the case, for example, of women who have undergone an organ transplant;
• Those who are undergoing chemotherapy to treat a tumor. Chemotherapeutics have the side effect of reducing the efficiency of the immune system;
• People with diabetes mellitus. Diabetes promotes the proliferation of Candida albicans ;
• Subjects who have to periodically resort to dialysis (the so-called dialysis). This is the case for women with renal insufficiency ;
• Those who, thanks to a certain health condition, must undergo the insertion of a central venous catheter . The central venous catheter is a medical device used in long-term therapies, to administer fluids, drugs and other substances that the human body needs in the presence of certain conditions.

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 Complications of Vaginal Candida

For some women, vaginal candida is a relapsing / recurring condition , that is, it recurs from time to time; this situation is not serious from a clinical point of view, but it can have significant repercussions on the quality of the patient's sexual life.

• Furthermore, if it affects women in a state of immunosuppression or with particular diseases (eg diabetes), vaginal candida can degenerate into a systemic condition, known as invasive candidiasis (or invasive candida ).
• Invasive candida is the infection resulting from the passage of the fungus Candida albicans ( fungemia or funghemia ) into the blood and its spread to important organs, such as the heart ( endocarditis ), the brain ( encephalitis ), the eyes ( endophthalmitis ) or the bones ( osteomyelitis ).
• Invasive candida can be fatal for the patient, therefore it represents a medical emergency, which must be given immediate help.

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