What is the first-line treatment for vulvovaginal candidiasis?

• A. Azole antifungals
• B. Antibiotics
• C. Topical steroids
• D. Oral contraceptives

Answer: (A)

The first-line treatment for vulvovaginal candidiasis is azole antifungals. This class of medications, which includes drugs such as fluconazole and clotrimazole, directly targets the Candida species responsible for the infection. Azole antifungals work by inhibiting the synthesis of ergosterol, an essential component of the fungal cell membrane, which ultimately leads to cell death and resolution of the infection.

Vulvovaginal candidiasis is mainly caused by an overgrowth of Candida, most commonly Candida albicans. Given that the infection is fungal in nature, the use of antifungals specifically designed to eliminate fungal organisms is appropriate and effective. Other treatments mentioned, such as antibiotics, are primarily used to treat bacterial infections and would not be effective against yeast, while topical steroids could potentially exacerbate the condition. Oral contraceptives do not address the underlying fungal infection and are not used as a treatment for candidiasis. Thus, azole antifungals are the recommended first-line therapy for successfully treating this condition.