Genital infections

The drug of choice for self-medication is the imidazole clotrimazole, which is effective against various fungi as well as some types of bacteria. It is available in the form of vaginal tablets, suppositories and creams, and as a skin cream for application to the vulva, that is the external female genital organs.

Combination packs such as KadeFungin®3 Combination Pack, Canesten® GYN 3-day combination pack, Vagisan® Myko Kombi 3 Days or Canesten® GYN Once Combi Mycosis contain both a product for treating the vagina and one for the external genital area. They are recommended if the vagina as well as vulva are affected. The over-the-counter preparations are intended for a one- and three-day therapy. A total dose of 500 to 600 mg of active ingredient is used in both forms of therapy. However, there is a difference in dividing the amount of active ingredient: The vaginal tablet for the one-day therapy contains 500 mg of clotrimazole as opposed to 200 mg per tablet in the three-day combination pack. The advantage of the one-day therapy could be a better adherence, plus the fact that the symptoms recede more quickly.

For one day respectively three days, the patient inserts a vaginal tablet once a day in the evening before going to bed using the applicator provided. The easiest way to do this is to lie on your back with your legs slightly bent. At night, the active ingredient can spread easily and there is less leakage. After use, clean the applicator carefully with warm water. If the vaginal mucosa is very dry, the vaginal tablets will not dissolve sufficiently. A cream for intravaginal application by applicator is then more suitable.

Skin creams for external use should be applied thinly to the external genital organs up to the anus using the finger. External treatment should be carried out up to three times a day for one to two weeks.

Nystatin from the group of polyenes is a second-choice remedy and is only effective against yeast fungi. Corresponding preparations such as Biofanal® as an ointment, suspension gel, film-coated tablets, vaginal tablets or a combination pack (ointment plus vaginal tablets) should be recommended by PTA if clotrimazole is contraindicated.