What medications are used to treat symptoms of fungal vaginitis?

Vulvovaginal candidiasis (VVC) is a common inflammatory condition of the vulva and vagina caused by Candida species. Symptoms of VVC include:

1. Vulvar pruritus: Following infection with Candida albicans, patients commonly experience intense itching and a burning sensation in the vulvar area. The severity of pruritus may fluctuate—sometimes mild, sometimes severe—and may occur intermittently. In severe cases, patients may become restless, unable to sit or lie comfortably, and experience significant disruption to sleep and appetite.

2. Vaginal mucosal hyperemia: On physical examination, vaginal mucosal erythema is typically observed; in more severe cases, scattered petechiae or ecchymoses may be present. Additionally, when inflammation is pronounced, patients may experience dysuria and dyspareunia.

3. Abnormal vaginal discharge: Normally, vaginal discharge is white and semi-transparent. However, under the influence of Candida albicans infection, the discharge becomes thick, curd-like (resembling cottage cheese), and is often accompanied by increased volume and an unpleasant odor.

Pharmacologic treatment for VVC depends on disease severity. For uncomplicated VVC, topical antifungal agents are commonly used, such as clotrimazole or miconazole vaginal suppositories. Systemic therapy—for example, oral fluconazole—may also be employed. For complicated VVC, antifungal selection should be guided by fungal culture and susceptibility testing. Commonly prescribed agents include vaginal soft capsules, miconazole suppositories, and clotrimazole suppositories. All medications must be administered under physician supervision to avoid disease exacerbation.