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

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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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