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Around 75% of people with vaginas have at least one vaginal yeast infection at some point in their lives, while nearly half have at least two. [1] [9] Around 5% have more than three infections in a single year. [9] It is the second most common cause of vaginal inflammation after bacterial vaginosis. [3]
Candidiasis is a fungal infection due to any species of the genus Candida (a yeast). [4] When it affects the mouth, in some countries it is commonly called thrush. [3] Signs and symptoms include white patches on the tongue or other areas of the mouth and throat. [3]
Fluconazole is an inhibitor of the human cytochrome P450 system, particularly the isozyme CYP2C19 (CYP3A4 and CYP2C9 to lesser extent) [31] In theory, therefore, fluconazole decreases the metabolism and increases the concentration of any drug metabolised by these enzymes.
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In the days right after menstruation, vaginal discharge is minimal, and its consistency is thick and sticky. [12] When approaching ovulation, the rising estrogen levels cause a concomitant increase in vaginal discharge. [12] The amount of discharge produced at ovulation is 30 times greater than the amount produced directly following ...
The current first-line treatment is fluconazole, 200 mg on the first day, followed by daily dosing of 100 mg for at least 21 days total. Treatment should continue for 14 days after relief of symptoms. Other therapy options include: Nystatin is an effective treatment for mild esophageal candidiasis. [2]
The side effects of oral treatment are significant and people without an infection should not take these drugs. [36] Azoles are the group of antifungals which act on the cell membrane of fungi. They inhibit the enzyme 14-alpha-sterol demethylase, a microsomal CYP, which is required for the biosynthesis of ergosterol for the cytoplasmic membrane.
Ketoconazole has activity against many kinds of fungi that may cause human disease, such as Candida, Histoplasma, Coccidioides, and Blastomyces (although it is not active against Aspergillus), chromomycosis and paracoccidioidomycosis. [23] [13] First made in 1977, [20] ketoconazole was the first orally-active azole antifungal medication. [23]