Subject:  Candidiasis/Moniliasis

 

 

1.         Patient may be asymptomatic or report having one or more of the following:    

         pruritis, redness, swelling of external genitalia, thick whitish discharge.

 

2.      Microscopic identification of yeast forms in gram stain or KOH wet mount   

         preparation of vaginal discharge.

 

 

1.       Monistat or other over the counter yeast cream or Terazol prescription x 3-7 days depending on dosage, to be used intravaginally at bedtime. May use cream on vulva as well if symptomatic.

       

2.       If recurrent infection, review history of antibiotic usage and consider screening for diabetes and HIV infection, if not already screened. 

 

3.       If infection fails to resolve after 2 weeks x 2 treatment courses discuss use of Diflucan with Physician/Midwife

 

4.       Instruct the patient as follows:

 

·       Report all use of over the counter yeast preparations.

·       Observe correct perineal care (front to back wiping)

·       Wear cotton or cotton crotch panties

·       Avoid tight fitting pants and panty hose

·       Avoid using scented sprays and pads

·       Use tub baths and adequate perineal drying

·       Diflucan is Category C for use.  It should only be used under

     supervision of a physician/midwife

 

 

                                                            Prepared in conjunction with the

                                                            Division of Maternal-Fetal Medicine

Duke University Medical Center

 

 

__________________________________

Director 

Date

1.       Centers for Disease Control and Prevention.  Sexually Transmitted Diseases Treatment Guidelines 2006.  MMWR 2006:55 (No. RR-52-54).

 

 

The Clinical Care Guidelines Development Committee of the Perinatal Improvement Board of Duke University Health System has developed a series of multi-disciplinary protocols to offer guidance to health care providers who are caring for pregnant women with high risk conditions.

 

These protocols are designed to assist health care providers in the management of a variety of problems that occur in pregnancy and the time of delivery. They should not be interpreted as standard of care, but instead represent only general guidelines for the care of pregnant women with high risk conditions.  We recognize that services offered by individual providers depend not only on their training, experience and institutional resources, but on the medical facts and circumstances of the specific care situation.

The protocols remain the intellectual property of the Duke University Health System.  They cannot be reproduced in whole or part without the expressed permission of the Health System.

 

These protocols are reviewed by the Department of Obstetrics and Gynecology Division of Maternal-Fetal Medicine, the Department of Pediatrics Division of Neonatology and the Department of Anesthesiology Division of Women’s Anesthesia.  Please contact Andra H. James (andra.james@duke.edu), Chair, Clinical Care Guidelines Development Committee of the Perinatal Improvement Board with ideas for additional protocols.