What is the primary treatment for vulvovaginal candidiasis?

The primary treatment for vulvovaginal candidiasis is miconazole, which is an antifungal medication that falls under the class of azoles. Miconazole works effectively by inhibiting the synthesis of ergosterol, an essential component of the fungal cell membrane, thereby leading to fungal cell death. It is available in various forms, including topical creams and inserts, which are often preferred for localized infections like vulvovaginal candidiasis.

While fluconazole is also an effective treatment for candidiasis, it is typically used for more severe or recurrent cases, as it is an oral medication that provides systemic treatment. Nystatin is generally less effective for vulvovaginal candidiasis, as it is more often used for oral thrush or intestinal infections. Amphotericin B is usually reserved for serious systemic fungal infections due to its potential side effects and is not appropriate for common yeast infections like vulvovaginal candidiasis. Therefore, miconazole is the most suitable primary treatment for this condition.