What is the recommended treatment for recurrent yeast infections?

Hello doctor,

My mother suffers from recurrent breastfold yeast infections. She takes Bactrim twice daily for about three months to fend off bladder Escherichia coli UTIs (urinary tract infections). She was able to gain final control over the yeast after a few weeks when Canesten could not, by using Tinactin powder, even though it is primarily meant for athlete's feet. She has tried Lamisil and Dettol in the past with no success. Also, a couple of weeks ago, when she received cortisone injections for sacroiliac joint arthritis, the yeast flared up again. She also takes Saccharomyces boulardii probiotic yeast for antibiotic diarrhea and hopefully to indirectly fight the pathogenic yeast. What other topical treatments are available? Even with the best topical treatment, if moisture is present, it might not be effective. What are the overall recommendations?

Kindly help.

Hi doctor,

Thank you for the reply.

I meant to say she used the Canesten cream and Tinactin powder in combination. She is not going to use any more oral medications as she is already on a few for her heart. I had already mentioned that Ketaderm did not help, but that was two years ago. You stated Ketoconazole, which I believe Ketaderm contains. At least the Tinactin and Canesten kept it from getting red and eventually resolved it. Canesten is Clotrimazole-based. I do not know if a powder with that ingredient would be better than a cream. Then, if applying a powder that works is better than applying a cream when wet is optimal when you say 'long time to apply,' it is subjective.

Her last flare-up, which I had to look at myself as the caregiver only showers her once a week, was located on the far edge of the breast fold near the armpit, so she could not see herself thoroughly. I bought a full-size mirror behind the door so she could see herself clearly. There must be other topical medication ingredients than the three above.

Hi doctor,

Thank you for the reply.

If she were a 30-year-old female, I would consider giving her Ketoderm again. She stated that it is getting better with Tinactin and Canesten cream, so whether Ketoderm has any additional efficacy is unclear. It failed before.

How long would oral antifungal medication need to be taken? Any comments on the significance of oral probiotic yeasts? I would give her more, but I take it for IBS (irritable bowel syndrome), and it does slow down bowel movements, and I do not want constipation issues.

Hi doctor,

Thank you for the reply.

You need to educate yourself; there are indeed probiotic yeast products such as S. boulardii. It is similar to brewer's yeast, and there is a lot of anecdotal information regarding its benefits. Probiotics are not just good bacteria.