Our patient, Flora, was treated for a sinus infection with a broad spectrum antibiotic. Although the medication cured her sinus infection, the antibiotic caused a disturbance in the normal flora of her vagina resulting in a yeast infection. This is known as a superinfection

What is normal flora, you ask? Normal flora is a population of microorganisms that normally inhabit an area such as the skin, intestines, mouth, vagina and other areas of the body. These microbes are permanent residents and, when present in normal amounts, do not cause disease. The presence of normal flora in the vagina prevents an overgrowth of of a yeast called Candida albicans which is normally present in small amounts as part of normal flora within the vagina. Organisms, like Candida albicans, that do not cause disease in their normal habitat become pathogenic when allowed to overpopulate. If the normal flora is destroyed by antibiotics, the yeast grows uncontrollably and a vaginal yeast infection, or Candidiasis, occurs. Candidiasis is characterized by vaginal discharge, vaginal odor and itching of the vaginal/vulvar area.

Candidiasis is an example of a superinfection, or opportunistic infection. A superinfection is an infection that occurs after or on top of a previous infection especially following treatment with broad spectrum antibiotics. Antibiotics change the normal balance between microbes in the vagina by decreasing the protective bacteria that are also part of normal flora, thus allowing the candida to grow and result in the yeast infection.

Treatment of candidiasis may consist of oral medications or topical agents. Topical antifungal agents, such as miconazole or nystatin, are typical and available over the counter. Oral medications, such as fluconazole, are available by prescription. Some trade names for these antifungal drugs you may recognize are Monistat and Diflucan.

Yeast infections are a common complaint among women of childbearing age. Doctors diagnose a patient as suffering from recurrent yeast infections when the patient experiences 4 or more yeast infections per year. This condition affects around 5 percent of women. Women suffering from recurrent yeast infections can work with their doctors to help prevent new infections.

Keep the vaginal area dry and clean. Yeast flourishes in a moist and warm environment.
Choose cotton or cotton lined underwear over synthetic varieties, as natural fibers are more breathable.
Avoid wearing pantyhose, tights or tight clothing.
Change out of your wet swimsuit immediately after swimming.
Go without underwear while sleeping or change into fresh underwear before bed.

Don't use scented or dyed soaps, detergents or other personal hygiene products.
Choose unscented toilet paper. Dyed and scented toilet paper can cause irritation in some people that can trigger yeast infections.
Switch to free and clear or eco-friendly laundry detergents and fabric softeners, or go without fabric softener when doing your laundry.
Avoid scented tampons, sanitary pads and underwear liners.
Wash the vaginal area with a gentle cleanser--antibacterial deodorant soaps can upset the balance of bacteria and yeast in the vagina. Douches are also harmful to the balance of vaginal flora.

Choose condoms without spermicide if you experience frequent irritation from spermicides. Certain women are sensitive to the spermicide nonoxynol-9, and their repeated use of spermicidal condoms may lead to yeast infections.

Ask your sexual partner or partners to seek treatment or testing for yeast infections if you are experiencing recurrent yeast infections.
Talk to your doctor. Although a yeast infection is not a sexually transmitted disease, some doctors do recommend treatment for all sex partners if 1 person is suffering from an infection in order to help prevent recurrent yeast infections.
Refrain from sexual activity while you have a yeast infection.

5 Consider switching from a high-dose to low-dose hormonal birth control method if you suffer from frequent yeast infections.

Add milk products containing the bacteria acidophilus lactobacillus to your diet. Some examples are acidophilus milk, yogurt and kefir. Many natural health practitioners believe eating products containing this type of bacteria can help restore the balance of the vaginal flora and prevent yeast infections.


Reduce the amount of sugar in your diet. This recommendation is touted by many in the natural health community, but most doctors believe it does not have a direct affect on preventing yeast infections.

Make an appointment to see a doctor if you experience recurrent yeast infections and your suffer from HIV, Lyme Disease, Diabetes, Lupus or any other condition which affects the immune system. These can all be underlying causes of recurrent yeast infections.

Discuss treatment strategies for controlling your specific condition and for preventing and treating yeast infections.

Take any medication your doctor prescribes to control your condition and the overgrowth of yeast.

So, what caused Flora's itch? Flora's normal flora had become abnormal! Watch out for those antibiotics!