3) Treatment options for genital infections not normally considered sexually transmitted

Young person 13 to 15 years old (inclusive)

Vaginal candidiasis is rare in girls before puberty, but can occur in adolescents. Candida vulvitis can be treated locally with cream (clotrimazole cream 1% topical application 2 to 3 times daily), but is almost invariably associated with vaginal infection, which should also be treated with antifungal pessaries or cream inserted high into the vagina (including during menstruation). However, these are not recommended for pre-pubertal girls and treatment with external cream alone may be more appropriate. Intravaginal preparations (particularly those that require the use of an applicator) should also be avoided in young women who have not been sexually active and have no experience of using tampons, unless there is no alternative. The safety and efficacy of oral triazoles (for example fluconazole) has not been established in girls under 16 years but, treatment with single dose oral fluconazole 150mg may be considered for girls post puberty¹.

Young person 13 to 15 years old (inclusive)

Metronidazole gel 0.5% and clindamycin cream 2% are not licensed for use in children. In addition, intravaginal preparations (particularly those that require the use of an applicator) should be avoided in young girls who are not sexually active and have no experience of using tampons, unless there is no alternative.

1. BASHH National Guideline on the Management of Sexually Transmitted Infections and Related Conditions in Children and Young People (2021) [accessed 9 July 2024]