Complex treatment of chronic thrush. Scheme for effective treatment of thrush. The best suppositories for thrush

Despite the successes of modern medicine in the development of drugs, diagnosis and identification of risk factors for candidal infection, the problem of treating vulvovaginal candidiasis (thrush) in women is still relevant.

Over the past 20 years, the number of candida carriers, women with asymptomatic, chronic recurrent thrush, and women infected with Candida non-albicans has been growing; drug therapy in these groups is the most complex and requires care and high qualifications of the attending physician.

Fungi of the genus Candida themselves can develop resistance to medicines and respond poorly to ongoing measures, including due to the formation of persistent biofilms on the surface of the vaginal epithelium.

We will devote this material to the features of acute and chronic recurrent vulvovaginal candidiasis (thrush) in women.

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  1. Briefly about pathology

  Vulvovaginal candidiasis (VVC) is caused by fungi of the genus Candida. Most often they belong to the species.

  Candidiasis infection of the vulva and vagina is usually accompanied by the following symptoms:

  1. 1 White, cheesy or creamy discharge from the genital tract.
  2. 2 Itching and burning in the vagina, vulva area. These symptoms may worsen after hygiene procedures, use of intimate hygiene products, during sexual intercourse.
  3. 3 Impaired urination - pain, frequent urge.
  4. 4 Pain during sexual intercourse - dyspareunia.
  5. 5 Swelling and hyperemia of the vaginal mucosa, less commonly the vulva.

  Preference is given to azoles (fluconazole, clotrimazole, miconazole), which in this case more effective than nystatin. This approach makes it possible to relieve symptoms in 80-90% of patients who correctly completed the course (treatment regimens for uncomplicated thrush in Table 1).

  

  Table 1 - Treatment regimens for vaginal candidiasis (thrush) in non-pregnant women according to CDC recommendations, 2015

  If the symptoms of candidiasis persist after a course of therapy or a relapse develops over the next 2 months, then the patient is sampled for culture on a nutrient medium in order to clarify the dominant type of candida and determine their sensitivity to known antimycotics.

  The mechanism of development and pathogenesis of recurrent vulvovaginal candidiasis has not been fully studied. Many patients do not have obvious predisposing factors that could lead to chronic infection.

  In chronic thrush, Candida non-albicans is more often detected (in approximately 10-20% of cases), which are insensitive to basic drugs.

  In case of relapse C. albicans therapy includes several courses of antifungal drugs:

  1. 1 Initial course - a short course using local or systemic drugs from the azole group. For a better clinical effect, some doctors suggest extending the use of local azoles to 7-14 days or prescribing fluconazole orally according to the regimen - 1, 4, 7 days of therapy at a dosage of 100, 150 or 200 mg, respectively.
  2. 2 Maintenance course. For 6 months, fluconazole is taken once a week at a dose of 100-150 mg. If this is not possible, then topical azoles are prescribed in intermittent courses. This therapy is effective, but 30-50% of women experience relapses after discontinuation of medications.

  For Candida non-albicans, the optimal treatment regimen has not been established. It is proposed to use local or systemic drugs from the azole group (except fluconazole) for 1-2 weeks. In case of relapse, the use of boric acid (vaginal gelatin capsules 600 mg) is allowed for 14 days once a day. This scheme leads to recovery in 70% of cases.

  Azoles can be used in pregnant women in the form of vaginal suppositories or vaginal cream. Taking medications internally is prohibited.

  4. Program DGGG, AGII and DDG (2015)

  According to this provision, a situation where a woman with normal immune status fungi of the genus Candida are detected in the smear, but there are no symptoms and does not require treatment (exception: pregnant women).

  Acute vaginal candidiasis, according to these recommendations, is treated with the following drugs:

  1. 1 Local therapy with nystatin preparations for a course of at least 6 days.
  2. 2 Local therapy with drugs based on clotrimazole, econazole, miconazole, etc.
  3. 3 Systemic therapy (fluconazole, itraconazole orally).
  4. 4 Cyclopiroxolamine vaginal cream, vaginal suppositories, course for at least 6 days.

  All of the above options have approximately the same effectiveness for acute vaginal candidiasis. Cure rates (clinical and laboratory) are up to 85% a week after completion of the course and 75% after 1-1.5 months.

  In pregnant women, the use of imidazoles is more effective than polyenes (comparisons were made with nystatin). For asymptomatic carriers, it is recommended to carry out preventive treatment. Its purpose is to prevent infection of the newborn.

  For chronic thrush, two-stage treatment is proposed:

  1. 1 Initial course (relief of symptoms, normalization of laboratory parameters).
  2. 2 Maintenance therapy - local (clotrimazole) or systemic (fluconazole).

  European recommendations for the management of women with pathological vaginal discharge- IUSTI/WHO (2011) J Sherrard, G Donders et al. include treatment regimens for vulvovaginal candidiasis, trichomoniasis and bacterial vaginosis.

  Treatment regimens for thrush in non-pregnant women recommended by IUSTI/WHO are presented in Table 2 below.

  

  Table 2 - Regimens for the use of antifungal drugs in non-pregnant women, recommended by IUSTI/WHO (2011) for the treatment of acute vaginal candidiasis

  For thrush that occurs with severe itching, you can use ointments and gels with hydrocortisone. Patients receiving oral antimycotics (fluconazole, itraconazole) can use moisturizing creams (emollients).

  Treatment for chronic thrush includes:

  1. 1 Elimination of predisposing factors, correction of concomitant diseases.
  2. 2 Initial course - 10-14 days.
  3. 3 Maintenance therapy involves the prescription of antifungal drugs once a week, a course of 6 months.
  4. 4 Avoiding the use of soap and using moisturizing creams (emollients) will help cope with dry skin of the vulva.
  1. 1 Inclusion of another drug from the group of polyenes - natamycin (Pimafucin) into the basic therapy of thrush.
  2. 2 The use of natamycin for chronic recurrent thrush and infection caused by C. non-albicans.

  

  Table 3 - Treatment regimens for acute and chronic thrush in non-pregnant women according to Federal clinical guidelines. To view, click on the table

  7. Supportive therapy

  Auxiliary therapy for thrush can eliminate concomitant infections of the reproductive system, normalize the vaginal microbiota, and improve general state woman's body.

  1. 1 Correction of nutrition for thrush, exclusion of foods that promote the growth and reproduction of fungi. Undesirable foods include sugar and sweet foods, rich yeast baked goods. Diet therapy for thrush in more detail.
  2. 2 Vaginal candidiasis is often combined with intestinal dysbiosis. This confirms the need for an integrated approach in the treatment of vaginal candidiasis. You can supplement the regimen by taking natural probiotics – fermented milk products containing lactobacilli and bifidobacteria.
  3. 3 Thrush against the background of severe vaginal dysbiosis, gardnerellosis requires prescription complex drugs, for example, neo-penotran, polygynax, terzhinan. Their effect is to eliminate inflammation, act on anaerobes, gardnerella and fungi.
  4. 4 We cannot recommend drugs for restoring vaginal microflora (gynoflor, vaginorm, ecofemin) until a sufficient number of studies have been carried out on their effectiveness.
  5. 5 It is important to eliminate foci of chronic infection in the body, if any. In the presence of diabetes mellitus, dynamic observation and therapy by an endocrinologist is required.
  6. 6 We cannot recommend immunomodulators, dietary supplements, or homeopathy due to the lack of evidence. In our opinion, healthy image life, balanced nutrition, physical activity fully replace these groups of drugs.
  7. 7 Traditional medicine methods and herbal treatment are distracting in nature and have a placebo effect. They should not be used in women.

  8. The problem of candida resistance to antimycotics

  The problem of resistance of fungi of the genus Candida to antimycotic agents is no less relevant than bacterial resistance to antibiotics. Resistance to drugs of the azole group develops more often than others; the low sensitivity to azoles of C. non-albicans is of particular importance. The explanation lies in the mechanism of action of drugs in this group.

  By inhibiting enzymes associated with cytochrome P 450, the drug disrupts the synthesis of ergosterol, a component of the cell membrane of the fungus. This is how the fungistatic effect develops.

  Resilience is acquired in several ways. C. albicans is characterized by the accumulation of mutations in the ERG11 gene, which is associated with encoding the enzyme for ergosterol synthesis. It no longer binds to azoles, but forms bonds with the natural substrate lanosterol. The latter is converted into ergosterol during the reaction.

  Another mechanism is associated with excretion from the cell medicine using ATP-dependent transporters.
  Resistance to azoles is cross-resistance, that is, it develops to drugs of the entire group. In this case, it is possible to use polyenes.

  9. Evaluation of treatment effectiveness

  The criteria for the effectiveness of treatment are the following indicators:

  1. 1 Complete recovery, vagina sanitized: no clinical symptoms, signs of inflammation, lab tests(, inoculation on a nutrient medium) confirm the absence of fungus.
  2. 2 Improvement: reduction in the severity of symptoms of the disease, objective signs.
  3. 3 Relapse - the appearance of new symptoms of thrush, detection of the fungus by smear microscopy 2-4 weeks after the course of therapy.

  In the acute form, control is prescribed 14 days after the last dose of medication.

  10. Prevention of relapse

  To prevent relapse of vaginal candidiasis, factors that create favorable conditions for the growth and reproduction of fungi of the genus Candida should be eliminated.

  1. 1 Mycoses develop in warm and humid environments. This is facilitated by wearing tight clothing made of synthetic, poorly breathable fabrics. It is better to choose cotton, comfortable underwear. Linen should be changed daily.
  2. 2 Daily sanitary pads retain moisture and heat, creating an environment that promotes the growth of fungus. Changing them frequently can eliminate these shortcomings.
  3. 3 You should maintain a balance in the consumption of different food groups, give preference to vegetables, fruits, cereals, fermented milk products, lean meat. Sweets and flour are limited to a minimum.
  4. 4 You cannot use antibiotics without a doctor’s prescription, and you cannot extend the course for a longer period than the doctor recommended. Antibacterial agents can be combined with fluconazole (150 mg) in women with a history of vulvovaginal candidiasis.
  5. 5 Glucocorticoids, when used over a long period of time, also promote the growth of fungal flora. They should not be used without a doctor's prescription.
  6. 6 Antifungal drugs should not be used without the advice of a doctor, as in the case of antibiotics, this leads to the development of resistance in fungi of the genus Candida.
  7. 7 The CDC does not recommend treatment of sexual partners for thrush in women.
  8. 8 It is recommended to visit a gynecologist at least once a year in the absence of complaints, as needed if there are any symptoms from the reproductive and urinary systems.

  The information presented in the article is intended to familiarize you with current trends in medicine and cannot replace a face-to-face consultation with a specialist. It should not be used for self-medication!

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Today there is a large number of medicines for the treatment of thrush. Therefore, it is not surprising that when you go to a pharmacy, it is difficult to choose the necessary medicine. For those who want to better understand this abundance and carefully choose the appropriate drug, the following information will be useful.

The main question is: in what cases is it better to take pills, and in what cases to use creams and suppositories? After all, are these methods of application different in some way?

Medicines for the treatment of thrush, depending on the method of application, are divided into 2 groups - local and systemic:

1. Local - vaginal cream, tablets or suppositories.
   Advantages: safer, do not create resistance to them in fungi, create a high concentration of the substance with its minimal systemic effect, allow you to avoid unwanted side effects. Many of them can be used during pregnancy.
   Flaws: if the focus of a fungal infection is located, for example, in the intestines, local remedies will be ineffective.
   Medicines for local application(cream, tablets or suppositories) are injected deep into the vagina 1 - 2 times a day, morning and evening before bed. Treatment is carried out until recovery, on average 5-7 days, but with chronic thrush it may take more long time. Intravaginal forms of drugs are not used during menstruation.
   Local treatment is most often quite sufficient for new-onset thrush and its mild course.
2. Systemic - tablets or capsules taken orally, which are absorbed from the intestines into the blood and penetrate into all organs, tissues and cells of the body.
   Advantages: allow you to influence other foci of infection (for example, the intestines), as well as fungi that live in the thickness of the walls of the vagina, and not just on its surface.
   Flaws: have a large number of side effects and toxicity, including hepatotoxicity. Therefore, their use during pregnancy is contraindicated. The exception is the non-toxic but ineffective pimafucin.
   Systemic drugs are used in case of failure of adequate local treatment or with frequent relapses of thrush (more than 4 times a year).

According to the mechanism of action on fungi, antifungal agents are:

1. Preparations with fungicidal action– those that directly damage mushrooms and cause their death. More often these are products for topical use, because... when used, a very high concentration of the drug is created, sufficient to cause direct damage and death of the fungus.
2. Preparations with fungistatic action- those that suppress the proliferation of fungi, disrupting the synthesis of individual components necessary for the construction of its cell membrane. In this case, new mushrooms cannot form, but existing ones do not die. Once the fungistatic agent is removed, growth resumes. This mechanism of action is typical for systemic therapy drugs.

However, the most appropriate is the use of drugs that have both a fungistatic and fungicidal effect.

Local antifungal agents for the treatment of thrush (5 groups).
(International names are given first, and commercial names in brackets).

1. The largest and most frequently used group of antifungal drugs are “azoles”.
They block the synthesis of ergosterol, the main component of the cell wall of fungi. Without ergosterol, the integrity of the cell membrane is disrupted, the intracellular components of the fungus enter the extracellular space and the fungi die. Fortunately, ergosterol is not a component of the human cell membrane and “azoles” do not harm them.

• Clotrimazole (Amiclon, Candide B6 Antifungol, Candibene, Kanesten, Kanison, Clotrimazole).
• Ketoconazole (Livarol, Lotseryl).
• Fenticonazole (Lomexin).
• Isoconazole (Gyno-travogen Ovulum).
• Miconazole (Ginezol 7, Gyno-daktarin).
• Butoconazole (Gynofort)

All these drugs have the same mechanism of action and have approximately the same effectiveness, which depends on the sensitivity of the fungal flora to a particular drug.

2. Polyene antibiotics. They are used much less frequently, because less effective.

• Natamycin (Pimafucin, Primafungin)

3. Povidone-Iodine (Betadine, Iodoxide, Vocadine) - iodine compounds, contraindicated in case of dysfunction thyroid gland and during pregnancy, because may interfere with the formation of the thyroid gland in the fetus.

4. Combination drugs, including antibiotics and hormones.

• Klion-D 100 (miconazole + metronidazole)
• Polygynax (Neomycin + Polymyxin B sulfate + Nystatin)
• Terzhinan (neomycin + nystatin + prednisolone)

The use of combination drugs that include antibiotics wide range actions and hormones are not advisable for thrush, since they suppress the normal microflora of the vagina.

5. 5-10% solution of borax in glycerin. Currently, it is practically not used, because This is an ineffective method of treating thrush.

Antifungal drugs for systemic use for thrush (3 groups).

1. Group of “azoles” with systemic action.

• Fluconazole (Diflucan, Diflazon, Ciscan, Flucostat, Medoflucon, Forkan, Mikosist, Fluconazole).
  For a fresh episode of thrush, it is enough to take fluconazole at a dose of 150 mg twice with an interval of 3 days. For frequently exacerbating thrush, after such a double dose, 150 mg is prescribed once a week for 6 months. There is also a treatment regimen in which fluconazole is taken 150 mg every three days for 2 weeks. Fluconazole has high bioavailability and effectiveness, it penetrates into all tissues of the body, has low toxicity and the frequency of side effects. The downside is that C. albicans may develop resistance to fluconazole over time. If treatment with fluconazole does not respond, one should think about candidiasis caused by naturally resistant candida species. In such cases, antifungal therapy with the effective but potentially toxic amphotericin B is recommended.
• Ketoconazole (Nizoral). The average dose is 200 mg 2 times a day or 400 mg 1 time a day with meals. The average course of treatment is 7 days. Ketoconazole in tablet form has a predominantly fungistatic effect, but when applied topically in the form of creams and suppositories, its high concentration (1-2%) is created, which is sufficient to develop a fungicidal effect.
• Itraconazole For thrush, take 0.2 g 2 times a day for 1 day or 0.2 g 1 time a day for 3 days. For chronic recurrent fungal vulvovaginitis - 0.2 g 2 times a day for 7 days, and then for 3-6 menstrual cycles, 0.2 g on the first day of the cycle.

2. Polyene antibiotics

• Natamycin (Pimafucin, Primafungin). Efficiency is low.
• Nystatin. Currently not applicable, because is ineffective.
• Amphotericin B. Effective drug, however, it is used only for serious systemic fungal infections, because is extremely toxic. It is not intended to treat fungal infections such as thrush. The only exceptions are cases of persistent, severe candidiasis that is not treatable with other drugs, including fluconazole. But in these cases, treatment is carried out in a hospital.

Important! In all cases where it is impossible to do without systemic drugs from these 2 groups, it is necessary to take hepatoprotectors - drugs that protect the liver from toxic effects.

3. Caprylic acid (Candida Clear). It is a fatty acid found in coconut and palm oils. Caprylic acid prevents the growth of yeast fungi, and, above all, the genus Candida, and also maintains the normal balance of microorganisms in the intestines. This product does not have toxic effect and therefore can be used without hepatoprotectors.

General treatment regimen for thrush in women, depending on the course of the disease.

I. First-time thrush and mild course.
Most often, when thrush occurs for the first time and has a mild course, the use of topical medications is sufficient. These could be suppositories, creams or tablets with clotrimazole, ketoconazole, fenticonazole or others. For example:
— Lomexin (600 mg capsules) – one capsule intravaginally, repeat after 3 days.
- Or Livarol (vaginal suppositories 400 mg) - 1 suppository per day for 5 days.
- Or Pimafucin - 1 vaginal suppository for 5-6 days.
During menstruation, local treatment is not used.
In addition, for mild thrush, instead of topical medications, a single dose of fluconazole at a dosage of 150 mg orally is possible. Occasionally there is a need to repeat the dose after 3 days. However, we must remember the toxicity of fluconazole.

II. Chronic or recurrent thrush (more than 4 exacerbations per year). In these cases, combination therapy of systemic and local antimycotic agents is required.
Local remedies (suppositories, creams or tablets) with clotrimazole, ketoconazole, fenticonazole or others are prescribed 2 times a day for at least 2 weeks, followed by maintenance therapy.
Systemic drugs Fluconazole are used simultaneously with local agents - 150 mg orally on days 1, 4, 7, or for 10 days, then 1 capsule per week for 6 months.
For example:
Livarol (vaginal suppositories 400 mg) is prescribed 1 suppository (400 mg) 2 times a day for 10 days and then 1 suppository per day 5 days before each menstruation for 6 months. At the same time, Fluconazole (150 mg) is prescribed according to the above regimen.

Treatment of candidiasis (thrush) in men

As in women, when treating candidiasis in men, it is important not only to get rid of the fungus, but also to eliminate factors predisposing it, for example, an abundance of sweets in food.
For candidal balanoposthitis (damage to the glans penis and foreskin), local treatment is sufficient. Apply cream with clotrimazole, ketoconazole or fenticonazole. It is applied in a thin layer to the glans penis and foreskin 2 times a day for 8-10 days.
A single dose of fluconazole 150 mg is also possible.

Treatment of thrush in sexual partners

According to modern ideas, treatment of a sexual partner in the absence of symptoms of the disease is not necessary, but desirable.
However, if a woman has a chronic recurrent process, it is necessary to examine her partner. If fungi are detected, treatment should be carried out regardless of the clinical condition.

When treating a couple, the following treatment regimen is usually prescribed:
Fluconazole (150 mg) for both partners: a single dose is enough for a man, repeat the dose after 3 days for a woman.
It is also necessary to simultaneously use local remedies. Suppositories with Ketoconazole - for women. For a man - cream with Ketoconazole on the head of the penis. The duration of treatment depends on the form of the disease - acute or chronic.
During treatment, it is better to abstain from sexual activity.

What you should pay attention to before starting treatment.

Before you start treating thrush with antifungal drugs, it should be borne in mind that many of them, especially systemic ones, have a number of side effects and are extremely toxic to the liver and kidneys. Moreover, the use of systemic antifungal agents is sometimes contraindicated or unjustified, so it is necessary to compare the risk from thrush and the risk from taking these drugs.

In any case, before immediately resorting to taking systemic antifungal drugs, it is advisable to:

1. Consider whether you have recently taken antibiotics, hormonal drugs, including contraceptives, or immunosuppressants, which could disrupt the composition of the normal vaginal microflora or lead to a decrease in immunity.
2. Pay attention to your diet. Does it contain too many carbohydrates - sugar, buns and cakes, which create a favorable environment for mushroom growth?
3. Do you often douche? After all, this removes beneficial microflora.
4. Take a blood test for sugar, because... Thrush can often be the first sign of developing diabetes, and changing your diet can have positive results.
   All of the above factors can provoke the development of the disease, and if they are not eliminated, the use of even the most powerful remedies may be ineffective.

All medications must be prescribed by the attending physician, taking into account individual indications, contraindications, allergies, liver and kidney conditions, etc.

Thrush strikes suddenly, and when you least expect it. This disease is not only serious, but also dangerous. Many women do not attach importance to symptoms, try to ignore them and live ordinary life as if nothing was happening. But the manifestations of this insidious disease cause constant discomfort and sad consequences for the body. The correct treatment regimen for thrush is very important so that the disease is not only cured once, but is also guaranteed not to return again.

What will the article tell you?

Candidiasis is serious

Even if you somehow learn not to notice the curd-like discharge from the vagina and swollen genitals, then constant itching and pain, the inability to have sex, and problems with urination can ruin anyone’s life. And later, if the disease progresses to chronic stage, in parallel, dysbiosis will occur not only in the vagina, on the genitals, but also in the intestinal region, in the stomach, and urinary system.

The body becomes more vulnerable to diseases, which is aggravated by stress and the very rhythm of existence modern woman. And once having struck a person, candidiasis may never go away, returning in relapses or going into a chronic phase. And then the treatment regimen for candidiasis becomes much more complicated, and the recovery process takes much longer.

A damaged flora, in which there will be no living beneficial bacteria left at all, will create conditions for the emergence and rapid spread of a wide variety of infections, many of which will cause deterioration in health, sometimes difficult to correct.

If you were healthy yesterday, but today you feel strange symptoms, urgently contact medical care. Yeast-like candida fungi, which are the cause of thrush (hence the name of the disease - candidiasis, and it is called thrush because the discharge is similar to dairy products), have become more active and have begun their “work” of destroying your microflora.

When thrush occurs, the treatment regimen involves active steps to restore the body's flora. Candidiasis is a microflora disorder. Fungi, “dormant” in the body, begin to multiply furiously with any stress or drop in the level of protection, which can arise for various reasons.

Causes of candidiasis

There is no single cause, but there are many factors that give rise to the cause, increasing the risk of developing the disease.

• Infection through sexual contact or sexual contact with someone who is infected (including HIV).
• Taking certain medications, which include antibiotics, glucocorticosteroids and others.
• Stressful conditions.
• Aggression of environmental factors.
• Regular constipation, problems with intestinal function.
• Colds, endocrine disorders, decreased immunity.
• Hormonal changes, including during pregnancy.
• Vaginal or intestinal dysbiosis (physiological lack of living bacteria).

Symptoms of candidiasis

1. A discharge with the consistency of milk product appears from the vagina and has a sour smell. They can be tightly attached to the walls, or they can ooze out profusely. They can be like yogurt or sour cream - a coating, or they can be a curd-like mass.
2. Itching begins on the labia outside and inside. Itching is also felt in the vagina. Is it episodic or constant. May get worse at night, in a hot bath. It can also be felt when urinating.
3. During sexual intercourse, if you want to have sex at all, the sensation of penetration will not just be unpleasant. The same itching, dryness, burning of the vaginal walls. The entire lower abdomen may feel tight and painful.
4. Visually, when examined by a doctor, the vagina looks swollen, reddened, and there are small erosions on the mucous membrane.

Treatment regimen for candidiasis in womencan be prescribed only after a medical appointment and diagnosis. There can be no talk of any self-medication, baths, or homemade lotions. Even if you manage to relieve the symptoms, you need to understand that the fungus remains alive in the body and can begin to multiply again. Therefore, it is necessary to treat both thrush and its cause(s), and after getting rid of harmful bacteria, make sure that beneficial bacteria take their place.

Diagnosis

In order to diagnose the disease and correctly determine its stage, you will have to visit a gynecologist. Diagnosis is performed in one of two ways.

1. Bacterioscopy(a regular swab taken from the vagina).
2. Bakposev(cultural method). It is used when signs (itching and pain, discharge visible to the naked eye) are present, but the fungus is not detected in the smear. Then the secretions are sown in a medium specially designed for the rapid development of the fungus.

Effective comprehensive treatment

When treating candidiasis in women, drugs and a treatment regimen are prescribed in such a way as to not only remove external manifestations, but also to get a healthy flora that guarantees against relapses. Treatment for chronic thrush can take up to six months. In the prescription of tablets and suppositories or other antifungal drugs that kill pathogens, intervals are made during which the disease can return again. And during this period, it is very important to simultaneously restore the flora, giving the body protective powers. This means that treatment must be comprehensive and consist of several stages.

The first stage is antifungal

The treatment regimen for thrush in women includes drugs such as antifungals that suppress the vital activity of the Candida fungus. To increase efficiency and speed up the process, they should take orally(systemically, through gastrointestinal tract) And parallel locally(vaginal method). A group of antifungal agents with active ingredients is prescribed: clotrimazole, miconazole, fluconazole, econazole, intraconazole, butoconazole. The consistency can be dry, creamy or liquid.

According to the form of release, the first ones intended for oral administration include: powder mixtures, regular tablets and capsules containing powder inside, as well as various suspensions, concentrates, emulsions. The second, applied topically, include preparations in the form of creams, ointments, gels, suppositories and vaginal tablets.

The treatment regimen for thrush in women with medications is only initial stage , basic therapy. After sanitizing the flora and destroying pathogenic fungi, it’s time to move on to the second stage of treatment.

The second stage is the restoration of the flora

After antibacterial sanitation, if the sterile vagina is not immediately filled with beneficial microorganisms, a recurrent inflammatory process will not be long in coming. Therefore, at the second stage, a group of lactobacterial agents is prescribed. They become necessary when pathogens are defeated and destroyed, but the niches they occupied remain vacant. To occupy them, lacto- or bifidobacteria are required. Their intake necessarily includes a treatment regimen for chronic thrush in women.

Preparations created on the basis of bifidobacteria contain at least one hundred positive bacterial organisms. As soon as they reach the mucous membrane, their active reproduction begins in the proposed environment. Bacteria begin to colonize the vagina, clearing its walls of the remains of harmful bacteria and forming a “living shield” for pathogenic fungi. They create conditions that are impossible for harmful bacteria to reproduce and be active.

Strains consisting of lactic acid bacteria produce and secrete lactic acid into the vaginal environment. It creates a favorable living background for other living bacteria. The level of lactic acid should be at least seven percent of the total microflora.

Probiotic or bifid preparations include the following:

• Acylact– multicomponent, containing a number of acidophilic lactobacilli that raise the microflora. Release - in the form of suppositories, insertion intravaginally twice a day for the duration of the course.
• Acipol– is a synthbiotic, taken in the form of capsules three times a day.
• Trilact– includes three types of bacteria. It is considered very effective for thrush. Reception twice a day.
• Kipacid– a symbiotic in which lactobacilli act together with immunoglibulin.
• Bifidumbacterin– powder, which is brought to the state of suspension with any food liquid (kefir, sour milk) or water, and taken with meals up to four double servings per day.
• Probifor– powder, diluted with sour milk.
• Biovestin- an emulsion that should be taken as an active dietary supplement not with food, but half a hour before or an hour later. The drug is diluted (or washed down) with warm milk.

The third stage - folk remedies

The treatment regimen for thrush in women is enriched with the use of folk remedies. The following decoctions can be taken as maintenance therapy:

• echinacea;
• chagi;
• peppermint;
• St. John's wort;
• chamomile

Herbs are taken both internally and externally, as compresses, lotions and baths. Decoctions/infusions can be prepared from these plants and taken individually or in any combination, in parallel with the main treatment. In this case, the main therapy will be much more effective.

Direction alternative medicine, which is called apitherapy, recommends the use of properties in the treatment of thrush bee honey, containing an incredible amount of useful elements.

The product has anti-inflammatory, antibacterial, antiseptic, and tonic effects.

You can make applications with honey, place suppositories and tampons soaked in honey solution, and irrigate the vagina with water and honey. Baths with a decoction of herbs in which honey is dissolved are useful.

At the same time, the sweet product is taken orally. Just don’t wash it down with hot tea - if high temperatures the effect of honey is reduced.

Stage four - diet

Yes, as in the treatment of many diseases, dietary correction of the diet is indispensable. It is especially important to follow dietary restrictions when using a treatment regimen for recurrent thrush.

Candida fungus multiplies actively in a sweet environment. Therefore, sugar and sugar-containing products are what he especially “loves”. The second favorable factor is gluten. It contains white flour and everything made from it. Accordingly, in a diet supporting therapy there is no place for sweet foods, as well as products made from flour or even with its small presence.

The first important thing in adjusting nutrition is deletion harmful products . The treatment regimen for chronic thrush involves excluding from the diet:

• alcohol, even with low alcohol content;
• baked goods, confectionery products;
• ice cream, sweets;
• spicy foods and foods with excess salt.

At the same time, it is necessary to ensure that the diet contains foods containing live bacteria. These include all fermented milk products (only if they do not contain sugar), cottage cheese and cheeses.

Nuts because they contain essential oils, which raise tone and improve immunity high level, you must consume at least 80 g per day.

Legumes, which as a result of fermentation help to release live bacteria, are also indicated in the treatment of candidiasis.

Contains many live probiotics fermented White cabbage and Chinese cabbage kim chi.

The menu must also include:

• chicken, beef, veal meat;
• low-fat fish;
• vegetables and greens (especially carrots, lettuce);
• garlic and onion;
• spices (bay leaf, cloves, turmeric, cinnamon);
• grains and legumes;
• fruits - lemons, lingonberries.

It is possible to get rid of thrush forever. Don't let illness take over your body. Get healthy!

We can talk about a recurrent or chronic form of thrush if the disease worsens more than four times a year. Most often this is due to a weakened immune system, which is simply unable to fight the attack of a fungal infection.

Relapses are also common when running forms candidiasis, resulting in deep lesions on the vaginal walls caused by yeast-like fungi.

Treatment of chronic thrush in women is a long and complex process that requires a patient and attentive attitude to your health. The treatment process of a recurrent form has a number of its own distinctive features including lifestyle changes.

It's safe to say that just one pill from a commercial won't help matters.

Causes of development and specificity of chronic candidiasis

Statistics show that in most cases, the chronic form of thrush develops in people with serious disorders and severely weakened defenses. Since the disease can occur against the background of other pathological processes, it is not surprising that if you have complaints characteristic of candidiasis, your doctor may refer you to tests for the presence of sexually transmitted infections and hormonal levels.

To achieve a lasting therapeutic effect, it is important to adhere to the doctor’s recommendations. Self-medication can aggravate the situation and lead to serious complications. Before starting treatment, it is important to understand what caused the development of the disease in a particular case.

The following reasons most often lead to the occurrence of persistent candidiasis:

• chronic infectious processes. Infectious diseases genitourinary system greatly weaken the work immune system, as a result, it simply cannot resist the attacks of fungal agents;
• hormonal changes, for example during pregnancy, with diabetes mellitus, obesity;
• poor nutrition. This is especially true for sweet lovers. An incorrect diet can lead to and, as a result, cause thrush;
• uncontrolled and prolonged use of antibacterial agents;
• initiation of the disease in the early stages.

If speak about clinical manifestations persistent candidiasis, then they are similar to the usual form of the disease:

• unpleasant cheesy discharge with a specific odor;
• itching, burning of the genitals;
• swelling and redness of the external genitalia;
• discomfort when urinating.

As for the differences, in the chronic form the symptoms are more pronounced. And in addition to all of the above, cracks appear in the genital area.

How to get rid of chronic thrush?

Treatment of recurrent thrush includes not only the use of antifungal agents. It will take deep, long and serious treatment source, which led to immune disorders. If you want, it is important to influence the cause of its occurrence.

Treatment of the recurrent form includes detailed and comprehensive monitoring. First of all, of course, it is necessary to check the gynecological smear for flora.

The procedure for taking biological material is absolutely painless. The glass with the material is sent to the laboratory, painted, and the laboratory assistant looks at the smear under a microscope. This study helps to accurately identify or exclude the presence of fungal infection.

At positive result smear on the flora, the patient is prescribed an additional study in the form of bacteriological culture of a gynecological smear. In addition, it is important to find an experienced and qualified specialist to help you carry out the procedure.

How to treat chronic thrush?

Treatment is carried out under the strict supervision of a doctor. Prescribing medications is an individual issue that depends on the severity, form pathological process, as well as the characteristics of the body.

Treatment of chronic candidiasis is a multi-stage work; if you follow each “step” of the treatment process, then you can rest assured that you will be able to get rid of the hated disease.

Treatment regimen for chronic thrush

Treatment of recurrent thrush includes five main stages, namely:

• combating predisposing factors;
• diet;
• rejection of bad habits;
• drug treatment;
• folk methods.

Combating predisposing factors

The first stage includes three points:

• rational antibiotic therapy;
• maintaining and protecting the immune system;
• personal hygiene.

Let's talk in more detail about maintaining intimate hygiene in women with thrush:

• You should wash your hands thoroughly before and after washing;
• antibacterial soap kills fungal infections well, but at the same time it also has a detrimental effect on beneficial microorganisms, so it is better to use special products for intimate areas;
• Do not overuse baths;
• use an individual towel;
• frequent douching can only aggravate the situation, leading to disruption of the normal microflora;
• You should wash yourself at least twice a day, as well as before and after sexual intercourse;
• You should wash from front to back, this will prevent infection from the intestines;
• give up tampons;
• change pads regularly, as they become a favorable environment for the development of fungal infections;
• to avoid microtraumas, use soft toilet paper;
• wear natural underwear.

Separately, I would like to say about strengthening the immune system during chronic candidiasis. Patients may be prescribed immunomodulatory and vitamin complexes. As a rule, with candidiasis, a deficiency of vitamins such as A, C, E is detected.

These vitamins are wonderful antioxidants, ensure the normal functioning of the mucous membranes of the vagina and take an active part in the body's immune reactions.

To boost immunity, it is important to consume the following foods:

• sea ​​fish;
• olive oil;
• fermented milk products;
• pine nuts;
• citruses;
• dried fruits;
• greenery;
• carrots, etc.

Separately, I would like to mention the harmful effects of nicotine and alcohol on microflora. Even passive smoking greatly weakens the immune system and can lead to candidiasis.

Diet

Proper nutrition plays an important role in the fight against chronic infection. Patients should enrich their diet with foods that have antifungal properties. For example, pumpkin inhibits the growth of fungi. The well-known garlic, according to scientists, has pronounced antibacterial properties and suppresses the growth of fungal cultures.

In addition, it is important to fill the body with “competitors” of the fungal infection - beneficial bacteria. To do this, you need to eat unsweetened yoghurts with live cultures of beneficial microorganisms.

Drug treatment

Drug treatment of chronic thrush includes the use of the following drugs:

• systemic antimycotics;
• local azole therapy.

Popular antimycotics that experts prescribe for recurrent forms of candidiasis are:

• . This drug is considered the gold standard in the treatment of fungal infections. Fluconazole is effective against fungal infections various types. Doctors prescribe one capsule every three days. The course of treatment is three doses. To prevent exacerbations, one capsule is prescribed once a week for up to six months;
• . This is another effective antimycotic agent. Most often, itraconazole is used when fluconazole is ineffective or hypersensitivity to it. active substance. Take one capsule per day for a week. For prevention, itraconaol is taken one capsule on the first day of menstruation for three months.

Local therapy with azole drugs includes the following:

• . This drug has pronounced fungicidal and fungistatic properties, that is, it not only stops the growth of fungal infections, but also disrupts their vital functions. The tablet is inserted into the vagina overnight;
• bifonazole The product is an antimycotic drug with a wide spectrum of action. Bifonazole destroys the protective membrane of the fungal cell, which leads to its death. The cream is applied once a day for two to four months.

Prevention is the best cure

It is much easier to prevent a disease than to treat it, and this is especially true for thrush. include many aspects that are aimed at various areas of human life.

The first and fundamental points that will help prevent the disease are:

• stopping contact with infected people;
• maximum strengthening of protective forces;
• careful adherence to personal hygiene rules.

For those patients who have already undergone treatment, the following is recommended to prevent re-infection:

• use of barrier methods of contraception;
• early examination and treatment of diseases of the genitourinary system;
• timely treatment of disorders that can lead to weakened immunity;
• refusal of intimacy with an infected person.

The most important rule is to avoid self-diagnosis and self-medication. Don't focus on commercials and word of mouth. Only a qualified specialist with the necessary knowledge base will be able to prescribe the optimal treatment that will bring the desired result.

Is it possible to cure chronic thrush using traditional medicine?

Traditional medicine is not an alternative to traditional methods, but only a supplement. Despite the fact that they are generally reliable and safe, their illiterate use can lead to serious consequences. That is why alternative treatment should be carried out under the supervision of a specialist.

It is also worth noting that traditional methods can only slightly reduce the manifestations of clinical symptoms, but they do not affect the cause of candidiasis itself.

Let's consider effective and popular techniques:

• gynecological collection. The finished product can be purchased at a pharmacy. It can be used internally. To do this, pour a tablespoon of the product into a glass of water and boil for ten minutes. After straining, the decoction is ready for use. Also breast collection can be used as douches. To do this, four tablespoons of the prepared decoction must be diluted in a liter of warm water;
• local baths. To prepare the medicine you will need one teaspoon of copper sulfate, alum and boric acid. The ingredients should be poured with a liter of boiling water. Next, the product should be infused for two days in a dark, dry place;
• washing. To carry out the procedure, you will need medicinal plants. It is necessary to take the following plants in equal parts: chamomile, calendula, sage, yarrow, juniper, eucalyptus, birch and poplar buds. For one liter of boiling water there are two tablespoons of raw materials. The product should sit in a thermos overnight. The resulting infusion can be used for baths taken before bedtime;
• soda and iodine. One tablespoon baking soda should be dissolved in a liter of water, then add a teaspoon of iodine. The solution must be poured into a basin and sit for twenty minutes. This procedure should be done daily for a month.

Treatment of chronic thrush is long and painstaking work. You should not allow the disease to become your constant companion in life - as soon as the first symptoms of thrush appear, seek professional help.

Dear friends, hello!

Today we will talk to you about thrush.

Do people often come to you with this problem?

I hear your unanimous “yes”!

Certainly! Going to the pharmacy is much easier than dragging yourself to the clinic, taking a coupon, waiting a week or more... And no one cares that “there” everything itches, itches and burns.

And if the female doctor’s advice is “douche with baking soda and chamomile” or “insert a tampon soaked in kefir” (this is not fiction), then I would like to say a lot of “warm” words to him.

What kind of rubbish is this - thrush? Where does it come from? What should you find out from a customer who asks you for something for thrush? How is this infection finally treated? Why does it sometimes not go away? What to offer in the complex?

Shall we figure it out?

How do mushrooms enter the body?

We already talked about mushrooms once. But this was a conversation about mycoses and skin.

Among other pathogens of mycoses, I mentioned to you yeast-like fungi of the genus Candida.

They are the cause of thrush.

We can acquire them in the course of our lives, or we can receive them as a gift from our mother at birth, if she was visited by thrush just before giving birth.

In the first case, vulvovaginal candidiasis, as thrush is otherwise called, can be contracted through direct contact with a sick person, including sexual intercourse, through a shared towel.

In the second case, when passing through birth canal fungi fall on the child’s skin, settle on the oral mucosa, penetrate the body with amniotic fluid and become permanent residents of the large intestine and vaginal mucosa.

Vaginal residents

However, mushrooms are not permanent and not the predominant representatives of the vaginal fauna. Now I wrote this word and thought: I wonder why, when we talk about microbes, they say microFLORA? After all, “flora” is plants, and “fauna” is animals. Or are microorganisms more like plants?

The main inhabitants of the vagina are lactobacilli. They make up more than 90%.

Bifidobacteria and opportunistic microbes also live here in minimal quantities: gardnerella, mycoplasma, streptococci, staphylococci, anaerobes, etc.

Lactobacilli perform very important function: they protect the vagina from external microorganisms, restrain the excessive reproduction of “neighbors” and prevent them from going all out.

The vaginal epithelium is a multilayer structure. Like the stratum corneum of the skin epidermis, young epithelial cells are born in the lowest layer, which divide, mature, move to the upper layers, and then desquamate.

The epithelial cells of the vagina contain glycogen. Lactobacilli break it down to form lactic acid. This maintains the acidic environment in the vagina at a level of 3.8-4.5, which protects it from pathogenic bacteria.

This makes it clear why you can’t use douching with a soda solution, which doctors love to recommend. Soda alkalizes the vagina and provokes gynecological problems.

And in general, any douching is harmful, because... wash away beneficial microbes, disrupt the ratio of good and conditionally bad bacteria. There are fewer good ones, but a holy place is never empty, so it is filled with those very conditionally pathogenic bacteria that were just waiting for this to begin to multiply.

In addition, soda dries out the mucous membrane, and dry mucous membrane is vulnerable. Therefore, a decrease in symptoms after this treatment method is the calm before the storm. The thrush will play out with renewed vigor, and other bad kids will join the mushrooms. Bacterial vaginosis will develop.

What does the first day of the cycle have to do with it?

You may have seen in doctors' prescriptions that for recurrent thrush they are prescribed on the first day of menstruation.

Do you know why?

The vaginal epithelium is hormone dependent. Estrogens help its cells accumulate glycogen and, therefore, break it down to release lactic acid. They also ensure the adhesion of lactobacilli to vaginal epithelial cells.

But in the first days of the cycle there is little estrogen.

During this period, a large number of destroyed endometrial cells and blood cells enter the vagina, and the environment here shifts to the alkaline side (pH increases to 5.0-6.0).

Therefore, the risk of getting thrush at the beginning menstrual cycle increases.

What causes vulvovaginal candidiasis?

Why is vaginal candidiasis called “thrush”?

Because the discharge in this disease resembles sour milk.

So, the most common factors that provoke the appearance of thrush:

1. . They destroy not only harmful, but also beneficial microbes, including those in the vagina, i.e. lactobacilli. There are fewer of them, they cannot fulfill their protective function, and the fungi begin to multiply intensively.
2. . During pregnancy, vaginal candidiasis occurs 2-3 times more often.

Sometimes thrush is a marker of pregnancy, when the test still shows nothing, but the fungus is already right there!

This is explained, firstly, by a physiological decrease in immunity during this period in order to reduce the activity of the immune system, which regards the fetus as a foreign body that needs to be expelled.

Secondly, hormonal changes occur, as a result of which there is too much glycogen in the vaginal cells, and this is also bad. Lactobacilli do not have time to break it down, and it provokes the proliferation of fungi.

1. Violation of hygiene rules. This is the use of tampons, which are sometimes in intimate place all day, collecting all representatives of the vaginal fauna. This also includes excessive use of antiseptic products not intended for intimate hygiene. They, like antibiotics, destroy everyone, without understanding who is right and who is wrong.

Keep this in mind and tell customers that tampons need to be changed every 2 hours!

Some gynecologists are not only against tampons, but also against panty liners, because they interfere with oxygen access to the intimate area.

1. Swimming pools. Chlorinated water dries out the mucous membrane, which leads directly to vaginal dysbiosis.
2. Clothes and some toiletries. These are tight trousers and jeans that pinch and rub in intimate places, disrupting blood circulation and reducing local protection. The same applies to thongs.

We already talked about the journey of microorganisms through thongs from point K (intestines) to point B (vagina).

Let's add here panties made of synthetic materials that retain heat and moisture, which is why mushrooms grow as if after rain. So, away with lace sexy lingerie, long live the good old hebeshechki!

1. Thrush is often brought from warm countries. Firstly, climate change is for the body, as a result of which it decreases. Secondly, this means increased humidity in an intimate area if you spend the whole day in a wet swimsuit.
2. Hypothyroidism. As you know, thyroid regulates ovarian function. With its hypofunction, hormonal disturbances in the reproductive system are ensured. Little estrogen means little glycogen in the vaginal epithelium. There is little glycogen, lactobacilli have nothing to break down. There is nothing to break down - lactic acid is not formed in the required amount. Lactic acid is not formed - the acidic environment in the vagina is not maintained.
3. Love for sweets. It turns out that mushrooms have a terrible sweet tooth. Therefore, during the treatment of candidiasis, doctors advise giving up sweets and starchy foods. For the same reason, thrush often visits.
4. Combined hormonal. They are on this blacklist because they create female body more low level estrogen than natural.
5. Estrogen-containing hormonal preparations for HRT. Here is the other extreme: there is a lot of estrogen, the level of glycogen in the cells increases, it draws water onto itself, the mucous membrane loosens, the pH shifts to the alkaline side. In 20% of women, glucose tolerance changes.
6. Glucocorticosteroids, immunosuppressants – i.e. drugs that reduce immunity.

How does thrush manifest?

It is not difficult to recognize thrush.

The following complaints may occur:

1. Itching, burning, discomfort in an intimate place, which intensifies in the evening.
2. White cheesy discharge without odor. People call them “beli”.
3. Pain during sexual intercourse.
4. Burning when urinating.

Thrush also occurs in men, and then white plaques, redness, and swelling appear on the genitals. The remaining complaints are the same as in women, but they are less pronounced.

To confirm the diagnosis of candidiasis, a smear is taken and a culture is done.

What forms of thrush exist?

There are 2 forms:

1. Acute candidiasis. Lasts no more than 2 months.
2. Chronic candidiasis. Lasts more than 2 months.

Chronic candidiasis is divided into 2 types:

• Recurrent – ​​symptoms go away completely after treatment, but exacerbations occur at least 4 times a year.
• Persistent – ​​symptoms are constantly present to varying degrees. After treatment they subside somewhat.

What questions should the buyer ask?

When you are asked to give something for thrush, you do not need to immediately offer an antimycotic. Talk to the customer. Why did she think it was thrush?

Questions could be:

1. Did your doctor give you this diagnosis?
2. How does the disease manifest? Is there itching, burning, or pain when urinating? What kind of discharge? (interested in color, consistency). White, curdled ones are thrush. If others, then the big question is what it is. Possibly an STD, and it makes no sense to recommend Fluconazole.
3. Is this your first time, or have you already had similar symptoms? If you have already had thrush, find out how often exacerbations occur.

The fluconazole treatment regimen depends on the severity of symptoms and the frequency of exacerbations.

Now some of you are reading these lines and thinking:

- Yeah, the line is halfway across the pharmacy, and I’m going to be interested in the discharge?

In order not to embarrass the customer and not to embarrass yourself, it is better to go out to her in the hall with the words: “I’ll come out to you now, I need to clarify something,” then, taking her aside, ask her these questions, since without this your recommendations may not be entirely literate.

General treatment regimen for thrush

The treatment regimen depends on several factors:

1. Acute or chronic process?
2. Is it just thrush? Often fungi are combined with other representatives of opportunistic flora, so the task becomes more complicated.
3. How severe are the symptoms?
4. Are there any concomitant diseases?

Comprehensive treatment of thrush includes:

1. Systemic antimycotic.
2. Local antimycotic.
3. After the course of treatment - a vaginal eubiotic to restore vaginal flora.
4. For chronic thrush -.

Fluconazole and Itraconazole are most often used for systemic therapy.

Treatment regimen for thrush with Fluconazole

There are different treatment regimens for Fluconazole, but the most logical one seems to me to be the following:

1. Not copious discharge, minor itching and discomfort or new-onset thrush:

Fluconazole 150 mg once for both men and women.

1. Itching, burning, discomfort, heavy discharge, 1-4 episodes of thrush per year:

Woman: Fluconazole 150 mg twice with an interval of 72 hours.

Man: 150 mg once.

1. Recurrent thrush (more than 4 episodes per year):

Woman: 150 mg three times with an interval of 72 hours. Then 150 mg once a week for 6 months.

Man: 150 mg once.

If Fluconazole is ineffective, see a doctor for examination!

If the diagnosis of candidiasis is confirmed, the doctor may prescribe, for example, Itraconazole 200 mg 2 times 1 day or 200 mg 1 time per day for 3 days.

Other

We influence mushrooms in their habitat

For local treatment, if the symptoms are definitely thrush, in my opinion, it should be a single drug: Pimafucin, Livarol, Zalain, Clotrimazole, Ginezol 7, Ginofort.

For women, most often these are suppositories or vaginal capsules/tablets, for men - cream.

The duration of treatment is different for each drug.

The average duration of use of the cream for a man is 7-10 days.

As for combined remedies (Terzhinan, Polygynax, Klion D, etc.), using them for thrush is like cutting your finger and at the same time smearing it with iodine. With the antifungal component we will destroy the fungus, and with the other, beneficial microbes, while reducing local immunity, which in itself is the cause of thrush.

They are usually prescribed for combined fungal and bacterial infections.

You ask: But how can you recognize her?

Firstly, a bacterial infection is manifested by “colored” discharge (yellowish-greenish).

Secondly, unpleasant smell.

Third, it can give in the stomach, deterioration in general health.

And then, most likely, you need Macmiror, Flagyl or a broad-spectrum antibiotic inside. Plus combined local remedy such as Terzhinan or Polygynax.

Restoring microflora

Food for thought. In the instructions for such drugs, candidiasis is listed as a contraindication, but doctors prescribe them in the complex treatment of thrush. How to understand this?

I haven't found any clear explanations for this. Moreover, opinions are divided as to which environment Candida mushrooms reproduce best in: some say that it is acidic (which I do not agree with), others say that it is alkaline. If we assume that they like an acidic environment, then how can we explain their existence in the large intestine, where the environment is slightly alkaline?

And yet: why are these drugs contraindicated for candidiasis?

I believe that firstly, because of the excipients. For example, in the drug Acylact it is written that bacteria are cultivated with the addition of sucrose-milk medium, and mushrooms, as you now know, love sweets.

Secondly, against the background of candidiasis, the affected cells of the vaginal epithelium contain little glycogen, so lactobacilli will not have enough nutrient substrate, and candidiasis will only get worse.

But after the end of antifungal therapy, with negative smears for the fungus, these drugs will come in very handy.

What do you think about this?

Understanding immunity

For recurrent candidiasis, the doctor may prescribe Viferon, Genferon, Polyoxidonium in suppositories, etc.

We take proper care

And ideally, especially with recurrent thrush, it is good to use a special intimate care product that will maintain an optimal environment in the vagina (for example, Lactacid).

During treatment:

1. Use only cotton linen.
2. Avoid thongs, tight trousers and jeans.
3. Eliminate sweets and starchy foods from your diet.
4. You should abstain from sexual intercourse during this period.
5. Both need treatment.

Why is thrush treatment often ineffective?

I found 5 reasons for this:

By the way, if a woman has doubts that it is thrush, you can offer her the FrauTest Candida.

What can you do for thrush during pregnancy?

Pimafucin: suppositories, tablets. The rest is all with some reservations.

That's all I wanted to tell you today.

How did you like this article, friends? If you want to add something, comment, or ask questions, write in the comments box.

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With love to you, Marina Kuznetsova