Get your health question answered instantly from our pool of 18000+ doctors from over 80 specialties

148 Doctors Online
Doctor Image
Dr. Andrew Rynne

Family Physician

Exp 50 years

I will be looking into your question and guiding you through the process. Please write your question below.

Suggest treatment for recurrent yeast infections

Answered by
Dr. Madhuri N Bagde


Practicing since :2001

Answered : 1390 Questions

Posted on Thu, 14 Aug 2014 in Skin Hair and Nails
Question: My daughter XXXXXXX has been battling a recurrent yeast/bacterial infection for two months now. She has been seen by her OB GYN several times, as well as a dermatologist due to the skin infection in the anal area that has now appeared. It seems that we can't get the yeast infection under control. She has been on diflucan, and a cream on an off since May. Now the cream burns her so we have stopped. Last week her gynecologist put her on a 5 day application of metradinazole vaginally which helped during the week and for 3 days. As of yesterday, she felt it coming back- inclusive of discharge. This week she is due with her period.
I am at my wit's end with this and it is very upsetting. I spoke with her dr. last night and she said she wants XXXXXXX off all meds for two weeks to let her body try to sort it out. I am concerned that the yeast infection will begin raging again and spread to the anal area again (which seems to be under control.) From your experience, should XXXXXXX be on metradinazol by mouth ? That seems to have a higher success rate from my research.
I am asking for her medical records today and going to seek out a gynecologist at a NY top hospital. Do you think I should be taking her to an internist or a different specialist or should I stay with a gynecologist ?

Just don't know what more to do on this. Should we be controlling her sugar or yeast intake ? or keep a food diary ? Some people say that that could affect this as well.

Much appreciated-
Answered by Dr. Madhuri N Bagde 1 hour later
Brief Answer:
detailed answer below

Detailed Answer:
Hello and welcome dear XXXX

I understand your concern well.

Please do not worry. Things will sort out.

I understand that your daughter is 21 years and is having recurrent yeast infections. They are not responding to treatment.
She has received metronidazole and it has recurred.

First of all metronidazole is not active against yeast. Yeast is a fungus and metronidazole is an antibiotic and not an antifungal agent. So metronidazole acts against bacteria and certain parasites like gardenella vaginalis. Hence it is not advisable to use it for treating a confirmed yeast infection.

If she is having the issue since a long time then swabs and microscopy must have been done and I assume that yeast is confirmed.

Now about the management. I will first explain the female vaginal physiology and then you can decide about the management options.

The vagina has naturally got a few bacteria inside it called vaginjal flora. They are a normal part of the vagina and thier presence is very important for vaginal health. If there are infections or repeated use of antibiotic s then this normal flora gets disturbed and then other organisms like yeast [ we call them opportunists as they grow only when the normal ones are decreased] begin to overgrow and cause infection. The predisposing factors for these are repeated use of antibiotics so that the vaginal organisms are killed, douching as water affects the vaginal ph and hence normal organisms cannot grow or decreased immunity due to any reasons like diabetes or HIV etc.

So as of now she has already received too many drugs. I agree with your doctor who says that let it rest for a while. Use of probiotics is the only treatment advocated now. I would also advise to rule out other concomittant infections like bactrial or parasitic ones that may also lead to vaginal discharge.

Metronidazole is not recommended at present as it does not act against yeast.

An immunological evaluation as well as blood sugar testing is also needed.

With these it will be possible to move forward. Also do not use local steroid creams as they decrease local immunity and hence predispose to infections.

Consulting a gynecologist will be fine as we are the ones that commonly deal with these issues and you have already seen a dermatologist. Drugs active against yeasts are fluconazole and ketoconazole and not metronidazole. So kindly please reconfirm which drug you meant.

Do not worry. Let me know if there are any more queries.

Hope this satisfies your query.
Thanks for using HCM.     
Feel free to ask any more questions that you may have.
Dr Madhuri Bagde
Consultant Obstetrician and Gynecologist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Madhuri N Bagde 47 minutes later
Yes, XXXXXXX was on the metrodinazole and has not done a ph test, which shows at a normal range. However, she is still having abnormal discharge and similar infection manifestations. The original swab tested positive for yeast among other bacteria- which then spread to the anal area as well. I do not, however, think that she has a current yeast infection, but am at a loss as to how to respond going forward.
Yes, XXXXXXX was also on fluconazole as well, prior to the metrodinazole. Perhaps the best way to go, as you said, is to leave her alone for a couple of weeks and then see how things go. The blood sugar test is a good idea as well. Would that be ordered by her gynecologist or should I speak with her internist ? She just had a physical in XXXXXXX where blood work was done as a part of her exam. I can ask for the blood work results to review.

Thank you very much Dr. It is very helpful having someone else to speak with about this. We feel very lost with this situation.
Kind Regards,
Answered by Dr. Madhuri N Bagde 32 minutes later
Brief Answer:
do not worry.

Detailed Answer:
Hello XXXX

Please go ahead and speak about the blood tests with the internists as well as the gynecologist. Also ask for the reports of the physical first as the sugar may already have been evaluated.

If it was a positive yeast earlier, now it may be a mixed infection. Even then better let it rest for atleast 7 days and then use mixed pessaries to be kept in the vagina alternating with lactobacillus pessaries to help restore the flora. Also wash the undergarments with hot water and change them twice daily till the infection clears as sometimes re contamination occurs from garments. Leaving the vulva open to air during night time also helps reduce growth of anerobic organisms and promotes healing. It also protects the area from moisture that may predispose to yeast infections. Also if she is sexually active then her partner must also be evaluated as sometimes these infections may be transmitted sexually.

So try these and let me know. I am always here for any more queries.

Take care. Hope she gets well soon. All my good wishes are with you.

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

The User accepted the expert's answer

Share on
Question is related to
Diseases and Conditions ,   ,  
Drug/Medication ,   ,   ,  

Recent questions on  Diflucan

doctor1 MD

Good day. I have noticed a strongish smell after urinating. The pharmacist said its either a fungal or bacterial infection. Diflucan was suggested, but that would only sort out a fungal infection not a bacterial?? i had been on antibiotics a while ago and my life is very stressful right now due to my mother being ill. In the past I would use Diflucan after antibiotics to get rid of the candida which antibiotics cause. NOw there is only a smell of the urine but no actual discharge.

doctor1 MD

My Daughter was misdiagnosed with herpes in Jan. where we later found that it was a bacterial infection. March she was dx. with type 1 DM. She has had 2 subsequent infections since tx: difulcan and flaagl. Today she baffled her OB with skin irritation that presents with white overlay of reddened dermial layer and raised papilli. this extends around the labia and diffusely encompassing the anus. 10/10 pain not relieved with 800mg of advil they aasked her to start taking Valtrex of which they have previously treated her with in conjunction with flaggl and diflucan. please advise

doctor1 MD

I am prone to yeast infections, and recently had a bad one. The doctor gave me three days worth of Diflucan and a cream that started with ket (can t remember the name) because apparently, I was rashy. I also had some blood and white blood cells in my urine. She took a urine sample and a culture and it came back positive for yeast. For years now, I only use baby soap, I have been drying myself with the heat off on a hairdryer, I take vaginal support probiotics daily. Right now, for about two weeks, I have had a really really weird stomach--it doesn t feel bloated, it just feels really full. I think I might be a little constipated? I just feel so uncomfortable. I have severly lowered my caffeine and sugar intake now because of this, hoping it would help. What do you think is going on with my stomach? Is that a symptom of a yeast infection? Or a side effect from the Diflucan? Or possibly something else?

doctor1 MD

I Have had blood on pillow and on parts of my sheets not always where my head would be. Last time I had blood all over my bed for over a year and it never showed on my nightgown or bras or clothes. I had blood twice on my bra and it was. Stage one...

doctor1 MD

I am on my second "bout" of dysphagia caused by esophagitis . Each time it takes 3-4 months to heal, before I can eat normally again. I am on Nexium 40 mgs daily and take 300 mgs of Ranitidine nightly. This will heal it again. But until then-this...

doctor1 MD

I had a double masectomy about four years ago. I had expanders put in. three months l blew up. I got a bad Staph infection. I was on keflex 1.5 Years. . I had DUCTAL INSITU STAGE zero.The breast surgeon gave us information and let us make the...

doctor1 MD

I have completed triple therapy treatment for helicobacter pylori infection shown at gastroscopy.Also had fungal infection of oesphagus.Still have white frothy saliva most of the gerd diagnosed.W hat is the dosage of Diflucan for the fungal infection please?.

Thank you.