Oropharyngeal candidiasis
[Clin Infect Dis 2016;62:e1-50.]
- Screen for HIV unless:
- infant
- known immunodeficiency/ immunosuppression
- recent use of inhaled steroids.
- If chronic suppressive therapy is required for recurrent infection, fluconazole 100mg PO 3x weekly is recommended.
- For denture-related candidiasis, disinfect dentures.
Usual Pathogens
Candida albicans
Occasionally non-albicans spp
Infants (Thrush)
| Empiric Therapy | Duration | |
|---|---|---|
| Nystatin | 100,000 U (1mL) qid | 7-10 days |
Mild
| Empiric Therapy | Dose | Duration |
|---|---|---|
| Nystatin susp | 500,000 U (5mL) qid | 7-14 days |
| or | ||
| Clotrimazole vag insert used orally | 100mg PO daily | 7-14 days |
Moderate-Severe
| Empiric Therapy | Duration | |
|---|---|---|
| Fluconazole | 100-200mg (3mg/kg) PO daily | 7-14 days |
Refractory - If oropharyngeal candidiasis refractory to these regimens, consult Infectious Diseases regarding need for further investigation and therapy.