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Consistent Candida Vaginal Infection, No Improvement With Medicines. Permanent Solution?

Posted on Tue, 28 May 2013

Question: I am 39 year old having 2 children. I have candida vaginal infection since 1995. Since then, I have tried many medicines like Clingen Forte for a week for conscecutive 3 months and pro-biotics for 3 months etc. Earlier I used to get twice or thrice a year but now every month I get it and I use Candiderma cream and Cansoft-CL cream. Whenever we have intercourse, my husband gets blisters and itchyness in penis. He uses Phytoral cream.Please suggest is there any permanent solution for this infection and preventive measures to take?

Answered by Dr. Achuo Ascensius (2 hours later)

Hello,
thanks for the query,

Yeast infections are predisposed by a number of factors such as;
-Poor hygiene after stools ( cleaning from back to front), keeping genital area moist and warm etc.
-Use of antiseptic soaps for vaginal douching
-use of tight non cotton under wears
-Use of hormonal contraceptives
-Prolonged use of antibiotics.
Yeast infection presents usually with itch and sometimes soreness and creamy white cottage cheese discharges.
However, these symptoms could be explain by other vaginal infections. The one thing which is absolutely necessary to do always whenever you have vaginal symptoms is a vaginal smear to identify the causative agent which could be yeast or bacterial or parasite. Diving into use of non specific drugs expecially antibiotics creates a disequilibrium that further aggravates the situation or creates another problem.

Clingen forte contains tinidazole which is effective in treating vaginal pathogens such as Trichomonas vaginalis and Gardnerrella and is not useful in treating Yeast infection. Probiotics are most often complementary options rather than curative. Candiderma contains a mixture of antibiotics, antifungal and steroid. Its effectiveness thus cannot be over emphasised. Cansolf is a good antifungal cream.

What you should do is to get a vaginal smear for microscopic examination, pH and Potassium hydroxide testing in order to get the exact organism causing the troubles. If its a yeast infection, you may want to change your antifungal drug from clotrimazole ( active ingredient in cansoft and part of candiderm) to others like ketoconazole, nystatin or fluconazole and also consider taking oral antifungal ( fluconazole). Most importantly prevent the predisposing factors listed above.

Hope this answers your query. If you have more query, i will be glad to help.
Best regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Achuo Ascensius (9 hours later)

Thank u for the advise. I had done vaginal swab test for culture and sensitivity on January 2012. The result was cultural characters: Large white creamy colonies on blood agar, Gram's stain: Yeast like budding cells which are gram positive in nature, Culture yields: Candida. Second test on February 2012 Culture yields : Candida. Earlier in 2009 January microbiology ( aerobic) for culture & sensitivity test was found sterile after 48 hours incubation. In October 2008 antibiotics sensitivity test was done. The result is specimen: vaginal swab, growth: Strepto Cocci, Moderate. Erythromycin: ++, Amoxycillin: R, Norfloxacine: ++, Nalidixic Acid: +++, Cephaloridine: ++, Nitro-Furantion: R, Cefotaxime: R, Cefriaxone: ++, Ampicillin: R, Gentamycin: +++ and for perennial wash I was using Lactacyd wash, since a week I have stopped it. I have 1 year old baby and feeding at present. Please suggest the medication

Answered by Dr. Achuo Ascensius (10 hours later)

Hello
thanks once more for the query.
SInce you are breastfeeding, you could take nystatine against the yeast infection. Ovules would do.
Best regards and if you have more query, i will be glad to answer.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Achuo Ascensius (27 minutes later)

Thank you for the advise. What is nystatine? Is it a tablet or Ointment ? How to use it and how long I should use it?

Answered by Dr. Achuo Ascensius (10 hours later)

Hello,
thanks once more for the query

Nystatine is an anti-fungal drug that is effective against the yeast infection. In cases of repeated yeast infections, treatment is aimed at;
-controlling risk factors,
-controlling digestive reservoir and
-use of effective medication.

Nystatine exist in vaginal ovules and oral tablets. The ovules are taken once or twice daily for 7 to 10 days while the tablets used in association with the ovules is to erradicate the digestive reservoir in repeated vaginal yeast infection; taken trice a day for seven days.

Instead of using nystatine ovules together with the tablets, you could use econazole 150mg ovules in plae of the nystatine ovules in order to prevent high amounts of nystatine in blood. Econazole 150mg ovule is inserted once for two conservative nights deep into the vaginal.

One main aspect of treatment is on prevention of risk factors which i mentioned in my first response.

Hope this answers your query. If you do not have further query, you could close the discussion and rate the answers.

Best regards

Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar