In young children, apply to the tongue and inside of each cheek. 1 ml of the oral suspension (100 000 IU) 4 times dailyĬhildren 6 months to 2 years: 1.25 ml 4 times dailyĬhildren over 2 years and adults: 2.5 ml 4 times dailyĪpply the oral suspension of nystatin or the oral gel of miconazole between meals keep in the mouth for 2 to 3 minutes, then swallow. In patients with frequent recurrences or extensive forms invading the esophagus (swallowing difficulty and pain), consider HIV infection.Ĭhildren and adults: 400 000 IU daily, i.e.

White patches on the tongue, inside the cheeks, that may spread to the pharynx.Other risk factors include treatment with oral antibiotics or high-dose inhaled corticosteroids. Intravenous caspofungin (200 mg 3 times daily), micafungin (50 mg daily), or anidulafungin (loading dose of 200 mg and 100 mg daily) can be used as alternatives to triazoles.Infection due to Candida albicans, common in infants, immunocompromised or diabetic patients.Posaconazole (200 mg 3 times daily) can be used with cure rate of 80%.In fluconazole resistant cases: Itraconazole (200 mg twice daily) can be used with cure rate between 64 - 80%.

Continuous prophylactic fluconazole use is more effective than intermittent use in response to relapses.

In pediatric patients: use itraconazole in a dose of 2.5 mg/kg/day.

Most immunocompromised patients respond initially to topical agents using the same regimen above but relapses occur rapidly unless fluconazole (400 mg [6 mg/kg} daily)is not used.

Medical treatment of oropharyngeal candidiais in immunocompromised patients:.

For refractory disease, consider the alternative regimen. Fluconazole is recommended in moderate-to-severe disease, and topical therapy with Clotrimazole or Nystatin is recommended for mild disease.

Note: Treat uncomplicated disease for 7–14 days.

Alternative regimen: Itraconazole solution 200 mg PO q24h OR Posaconazole 400 mg PO q24h OR Voriconazole 200 mg PO q24h OR Amphotericin B oral suspension PO q24h OR ( Anidulafungin 200 mg IV once THEN Anidulafungin 100 mg IV q24h) OR ( Caspofungin 70 mg IV once THEN Caspofungin 50 mg IV q24h) OR Micafungin 100 mg IV q24h OR Amphotericin B 0.3 mg/kg IV q24h.

Preferred regimen: Clotrimazole troches 10 mg TOP q4-5h OR Nystatin suspension or pastilles TOP q6h OR Fluconazole 100–200 mg PO q24h.

Systemic antifungal medication such as fluconazole or itraconazole may be necessary for oropharyngeal infections that do not respond to these treatments. Oral candidiasis usually responds to topical treatments such as clotrimazole troches and nystatin suspension ( nystatin - swish and swallow). Patients who are immunocompromised, either with HIV/ AIDS or as a result of chemotherapy, may require systemic treatment with oral or intravenous administered antifungals. Oral candidiasis can be treated with topical anti-fungal drugs, such as nystatin (mycostatin), miconazole or amphotericin B. Patients who are immunocompromised, either with HIV/ AIDS or as a result of chemotherapy, may require systemic treatment with oral or intravenous administered antifungals.Īny underlying cause, such as poor glucose control in diabetics, should be addressed. Associate Editor(s)-in-Chief: Ahmed Younes M.B.B.CH Overview Risk calculators and risk factors for Oral candidiasis medical therapyĮditor-In-Chief: C. Oral candidiasis medical therapy in the newsīlogs on Oral candidiasis medical therapyĭirections to Hospitals Treating Oral candidiasis Oral candidiasis medical therapy On the WebĪmerican Roentgen Ray Society Images of Oral candidiasis medical therapyĪll Images X-rays Echo & Ultrasound CT Images MRI Natural History, Complications and Prognosis Differentiating Oral candidiasis from other Diseases

Nystatin swish swallow