25 yrs ,65 kg , unmarried girl with vaginal itching since 1 yr after application of apple cider vinegar, kindly see her culture sensitivity reports and suggest treatment,on L/E - slight mixed vaginitis and 2 mm boil near fourchette, I have already given her AF kit(fluconazole azithromycin ornidazole),candid b cream , mycoderm NM cream - still no effect, kindly suggest treatment for this resistant vaginitis only near fourchette.l want to give her azithromycin, kindly give your opinion



Give antibiotic according to culture report,tell her maintain perineal hygiene,tab levocetrizine 5mg od×5 days and rule out STD HIV HbsAg VDRL and sugar fasting & Postprandial and partner treatment if she is sexually active.

Give her tab azithromycin 500 mg OD for 3 days and inj amikacin-500mg I/m for 5 days as these two antibiotics have ++ sensitivity in both culture reports. Advice her maintain perineal hygiene,use candid dusting powder to keep the perineum dry . As her hba1c is 5.8 advice her regular excersises for wt reduction

Give her a loading dose of long acting glucocorticoid like triamcinolone 80mg stat and azithromycin 1gm 3 days following by 500mg 7 days once a day. Clindamycin vaginally also required .

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do the routine tests. Give her Azithral 500bd, Allegra, and evaluate her after 1week

Dose of azithromycin

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C.Canditz 200mg bd for 3d,propygenta nf cream, no response add vag pessaries

Vaginal eaning.give suppositories fluids clavimox .metrogyl.Lyser d .Do all tests and treat as per their results

Add doxycycline 100 mg bd for 14 days+metrogyl 400 mg bd for 7 days.clingen v6 vaginal pessaries.

Because fungal inf will not be detected in c/s

Since she has received Azithro 1gm , now can give 250mg BD x 5 days Can add preprobiotic for vaginal health

Give Clotrimazole 100 mg vaginal tablets, t.i.d. and ask her to use v wash or similar antiseptic liquids meant for the washing of vagina only . at least 2 times a day and after the inter-course.

Alkaline vaginal pH with uti ??

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