Review Question - QID 109058

A 28-year-old female presents to her primary care provider complaining of vulvar pruritus. She reports that 3 days ago she developed an itching sensation that has gotten progressively worse. On review of systems, she also endorses mild dysuria and dyspareunia. The patient’s past medical history is otherwise significant for endometriosis for which she takes oral contraceptive pills. She drinks 5-10 glasses of wine per week and has never smoked. She denies other drug use. The patient is sexually active with men and has been with a new partner since her last office visit 3 months ago. At her last visit, she requested testing for sexually transmitted diseases and she tested negative for chlamydia, gonorrhea, HIV, and syphilis infection. His temperature is 98.6°F (37°C), blood pressure is 115/71 mmHg, pulse is 72/min, and respirations are 12/min. On physical exam, she has extensive vaginal inflammation with thick, white vaginal discharge. Her wet-mount microscopy can be seen in Figure A. Which of the following is the most appropriate treatment for this patient?