A 28-year-old woman presents to the outpatient clinic with complaints of vaginal itching and burning that have persisted for the past five days. She describes a thick, white, “cottage cheese-like” vaginal discharge and reports significant redness and swelling of the vulva. These symptoms are progressively worsening, causing discomfort during intercourse, although there is no associated foul odor. She denies pain during urination or systemic symptoms such as fever or chills. The patient is sexually active with one partner and reports no recent new sexual contacts. Her last menstrual period occurred two weeks prior. The patient’s medical history is significant for recurrent urinary tract infections, and she has recently completed a 7-day course of antibiotics for cystitis. She denies any chronic medical conditions or regular medications aside from oral contraceptives. She reports no history of similar symptoms in the past. On physical examination, there is notable erythema and edema of the vulva, with some excoriations likely due to scratching. Speculum examination reveals thick, adherent, white plaques coating the vaginal walls. A bimanual examination shows no cervical motion tenderness, uterine tenderness, or adnexal masses. Further diagnostic testing shows a vaginal pH of 4.0 (within the normal acidic range). Microscopy of the vaginal discharge using 10% potassium hydroxide (KOH) preparation reveals budding yeast and pseudohyphae. Which of the following medications can be considered to treat this patient’s disorder?
