Which treatment is recommended for vulvovaginal candidiasis?

Vulvovaginal candidiasis is a common fungal infection caused by Candida species, most frequently Candida albicans. The first-line treatment for this condition is often a single oral dose of fluconazole. This antifungal medication works by inhibiting the synthesis of ergosterol, an essential component of fungal cell membranes, leading to cell death.

Oral fluconazole is preferred due to its convenience and efficacy, as it allows for systemic treatment with just one dose, which can be very effective in clearing the infection. This advantage makes it particularly beneficial for patients who may have difficulty adhering to a topical regimen or for those who have recurrent infections.

While topical nystatin is an antifungal used for various fungal infections, it is generally not the first choice for vulvovaginal candidiasis as fluconazole tends to offer a more effective and streamlined treatment approach. Amphotericin B and IV echinocandins are typically reserved for more severe systemic fungal infections and are not recommended for uncomplicated vulvovaginal candidiasis due to their more complex administration and potential for side effects.