What medicines should be taken for candida infection?

Q: I am 29 years old, I had a missed abortion. My period cycle has been normal. My ultrasound reports were normal during pregnancy. I had minor pain in the lower abdomen in the beginning of the pregnancy. Mild UTI and Hb was 12g/dl. On completion of 3 months of pregnancy, I developed cramps but the pain was very minor. The doctor checked through ultrasound that the foetal growth was 12wks +/- 1 week and the heart beat and FHA movement were negative. I underwent D and C after which my vaginal bleeding did not stop. Ultrasound showed a cyst in my right ovary. I was given Overal G for the 1st month but the bleeding persisted. At the end of 3rd month my bleeding stopped and ultrasound report confirmed that there is no cyst. I developed Candidal infection with persistent white discharge. Culture and routine tests showed Candida, Klebsiela and Trichomonas and I took Canestian cream (repeated 2 times), Azithral (repeated 2 times), Candistat capsule (repeated 2 times), Lecgel (repeated 2 times), lecsoup (repeated 2 times) and some medicine for internal use. I still have the same problem and same becteria. I feel a minor pain on the right side of lower abdomen. Why is this infection persisting despite of so many medicines? Please suggest some good medicines? Will it affect if I want to conceive again? After D&C I still feel very weak though I have improved my diet.

A:Candida infections are common when your natural defences (immunity) drops, they are common in pregnancy (even in failed pregnancy like yours) as there is too much progesterone and the vaginal pH is high (normally the acidic pH in the vagina prevents infection). It is also common following a course of broad spectrum antibiotics like azithral. Also with contraceptive pills as they change the vaginal pH. I wonder why you took the pill to reduce the bleeding following the D&C. This is not a reason enough in itself. Anyway that is over and now you should get better. The immunity will improve on its own (about three months after the miscarriage) and stopping the pills (OCPs) and the antibiotics. The problem with fungal (like candida) infections is that they can be very persistent. You may have to take canestan like vaginal tablets many times and may also require a course of antifungal tablets. It is not possible (or ethically right) to prescribe on the email. You will have to see a specialist in your area to treat the candida infection permanently. For the bacterial infection you need antibiotics according to the culture sensitivity report and repeat cultures till it is eradicated. These infections can be nagging and persistent but with appropriate ttreatment should go away. Please follow it up carefully. With good treatment these infections should not interfere in your future ferility.