Review Question - QID 108629

A 26-year-old G2P1001 presents for a routine obstetric visit at 13 weeks gestation complaining of increased vaginal discharge for 1 week. The discharge is “white and clumpy” with accompanying severe vulvar itching. The patient has no other complaints. She has no past medical history, and her previous delivery was a spontaneous vaginal delivery. She states that she has been using panty liners for the last month or so due to mild stress incontinence. She denies having any new sexual partners or engaging in risky practices. At this visit, her temperature is 98.7 °F (35.1 °C), blood pressure is 119/74 mmHg, pulse is 82/min, and respirations are 14/min. The patient has no evidence of oral thrush. On pelvic exam, the vulva is erythematous with multiple excoriations. Speculum exam findings are shown in Figure A. Wet mount of a vaginal swab is shown in Figure B. Which of the following is the best treatment for this patient?