clip cat bao quy dau1% cream topically, 2 to 3 times daily. Hydrocortisone may be used for itching at any stage. Do not use stronger topical corticosteroids. Maintain remission with interval therapy; the treatment interval varies from weekly to once a month (eg premenstrually) depending on response. 100 000 units/5 g vaginal cream (1 applicatorful) OR 100 000 units pessary intravaginally, weekly. If oral antibiotics are required for intercurrent infection, the patient may have to return to continuous antifungal therapy after the course is completed to treat an antibiotic-induced flare of their condition. There is generally no need to treat the male partner or stop a low-dose oral contraceptive pill. However, in postmenopausal women, hormone replacement therapy may predispose to candidiasis and may have to be suspended (see postmenopausal chronic vulvovaginal candidiasis). Group B streptococcus (GBS) is a commensal in the gastrointestinal and genital tracts of up to 30% of healthy women of childbearing age. The use of intrapartum antibiotics has been shown to reduce the incidence of early onset neonatal infections with GBS and other penicillin-sensitive organisms and of maternal postpartum infections. · GBS bacteriuria (of any count/L). 1.2 g IV, stat, THEN 600 mg IV 4-hourly until delivery (category A). 600 mg IV, 8-hourly until delivery (category A). 38°C—potential chorioamnionitis), the spectrum needs to be broadened. For prolonged rupture of the membranes and maternal fever, see Severe sepsis, female genital tract source. 500 mg orally, 6-hourly for 7 days. 4.5), associated with a fishy smell, and inflamed vagina and cervix. However, it may be asymptomatic. Empirical treatment of partners is indicated. Investigation for other sexually transmitted infections should be considered.

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4.5, few or absent lactobacilli, and there is abundant Gardnerella vaginalis and/or Mobiluncus species, other mixed anaerobes and Mycoplasma hominis. Culture adds little to microscopy where 'clue cells' are seen. Treatment of male partner(s) is not indicated. 2% vaginal cream, 1 applicatorful intravaginally, for 7 nights. A single dose of metronidazole or tinidazole 2 g may be used, but the cure rate is lower and retreatment may be necessary. 400 mg orally, 12-hourly for 5 days (category B2). ], nystatin). The following have been shown to be effective in at least 80% of women. Occasionally topical therapy may itself cause irritation. Nystatin, although less effective, is generally better tolerated than the imidazoles. 100 000 units/5 g vaginal cream (1 applicatorful) OR 100 000 units pessary intravaginally, 12-hourly for 7 days. 150 mg orally, as 1 dose. If initial treatment fails, review the diagnosis and seek specialist advice. Symptomatic sexual partners (usually balanitis in the uncircumcised male) should be swabbed and only treated if infection is present (see Balanitis).
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