Treating vaginal thrush with oral or intravaginal medication: Which is better?

There was probably little or no difference between oral and intravaginal antifungals for short and long‐term clinical cure. Both routes of administration achieved clinical cure in over 70% of women. Oral antifungal treatment achieved a slightly higher mycological cure rate than intravaginal treatment. The decision to prescribe or recommend the purchase of an antifungal for oral or intravaginal administration should take into consideration cost, treatment preference and contraindications.

Unless there are contraindications or a previous history of adverse reaction to one route of administration, women who are purchasing their own treatment should be given full information about the characteristics and costs of treatment to make their own decision. If health services are paying the treatment cost, decision‐makers should weigh up the higher cost of oral antifungal administration with the marginal gain in mycological cure.