What are the treatment options for oral candidiasis?

Updated: Jan 17, 2020
  • Author: Richard Harold "Hal" Flowers, IV, MD; Chief Editor: Dirk M Elston, MD  more...
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Answer

Most patients can be treated with nystatin oral suspension. Usual treatment is 10-14 days or until 48-72 hours after resolution of symptoms. Dosage for preterm infants is 0.5 mL (50,000 U) to each side of mouth 4 times/day; dosage for infants is 1 mL (100,000 U) to each side of the mouth 4 times/day.

Treatment of adults with a topical agent such as nystatin (1:100,000 U/mL, 5 mL oral rinse and swallow four times daily) or clotrimazole troches (10 mg 5 times/day) usually is effective. In most patients, the duration of antifungal therapy should be at least twice as long as the termination of clinical signs and symptoms of candidiasis. Oral fluconazole, 100 mg once daily for 2 weeks, can be used for patients with more severe disease.

With denture stomatitis, improved oral hygiene with removal of dentures at night, vigorous brushing to remove plaque, and disinfecting (swish and spit) with chlorhexidine gluconate (Peridex) usually is adequate treatment. Topical therapy with clotrimazole troches or nystatin may be used for lesions that do not respond to the above measures. For more resistant cases, oral fluconazole, 100 mg/day for several weeks, in addition to the above measures, may prove effective.


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