One of the treatment for women that has been used for many years is topical applications of boric acid, which is used in pill form and inserted into the vagina, usually every day for a week. This is a good first treatment, and it may also be an option for yeast infections that do not respond to the other treatments already described. Treatment of the vagina with gentian violet is another, older treatment that is still used today, albeit less often. The gentian violet is painted onto the vaginal walls by a health care provider. As its name suggests, gentian violet is purple in color, and it stains the underwear.
If boric acid, gentian violet, and over-the-counter medications do not cure the infection, then a woman may benefit from using a prescription-strength cream such as terconazole or a tablet such as nystatin. Terconazole can be used for either three or seven days (the two different regimens are of similar efficacy, because the three-day cream is stronger). Nystatin is taken once a day for two weeks. For men whose infections are not cured by the over-the-counter creams, keto-conazole cream is a good alternative,- it is applied to the rash once a day for a two-week period.
The antifungal drugs fluconazole, itraconazole, and ketoconazole are available by prescription as oral medications for both men and women. They are as effective as the creams and are a little easier to use, but the oral medications may have more potential side effects than topical treatments. These include rare allergic reactions and liver toxicity (also rare), so these medications should be used with caution in people with liver problems. Fluconazole is taken as a single oral dose; itraconazole, orally for three days; and ketoconazole, orally for five days. These oral medications have adverse interactions with several other commonly taken medications, so it is important that the health care provider know about any other medications a person is taking.
Using oral antifungal medications does not appear to encourage the growth of drug-rcsistant yeast strains.
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