Which antifungal treatment is indicated for a thick, cottage cheese-like discharge?

The presence of a thick, cottage cheese-like discharge is characteristic of a yeast infection, most commonly caused by Candida species. The antifungal treatment indicated for this condition is oral fluconazole, which is an azole antifungal that works by inhibiting the synthesis of ergosterol, an essential component of fungal cell membranes. This action effectively reduces the growth of the fungus, alleviating symptoms and clearing the infection.

While other options like topical estrogen, metronidazole, and intravaginal progesterone have roles in treating different conditions, they are not appropriate for a yeast infection. Topical estrogen is typically used for vulvar or vaginal atrophy, metronidazole is effective against bacterial vaginosis and certain parasitic infections, and intravaginal progesterone is used in hormonal therapies, particularly in reproductive health contexts. Therefore, when addressing a case of thick, cottage cheese-like discharge suggestive of a yeast infection, oral fluconazole is the appropriate and effective choice.