From the Guidelines
Oral candidiasis is best treated with fluconazole 100-200 mg orally once daily for 7-14 days, as it is the most effective treatment for mild to severe disease, according to the most recent and highest quality study 1. The treatment of oral candidiasis depends on the severity of the disease. For mild disease, topical options like nystatin oral suspension or clotrimazole troches can be used, but fluconazole is generally more effective and has a higher cure rate 1.
- The dosage of fluconazole is 100-200 mg orally once daily for 7-14 days, which is the recommended treatment duration for most cases of oral candidiasis 1.
- For patients with HIV infection or AIDS, highly active antiretroviral therapy (HAART) should be initiated, and fluconazole 100 mg/day is recommended for the treatment of oropharyngeal candidiasis (OPC) 1.
- Topical agents like nystatin or clotrimazole can be used for mild disease, but they have a lower efficacy and are not recommended for severe or resistant cases 1.
- It is essential to address contributing factors such as proper denture hygiene, good oral hygiene, and avoiding tobacco use to prevent recurrence of oral candidiasis 1.
- Rinsing with warm saltwater can provide symptomatic relief, and patients should be advised to rinse their mouth after using steroid inhalers to prevent fungal overgrowth 1. The most recent study 1 provides the best evidence for the treatment of oral candidiasis, and its recommendations should be followed to ensure the best outcomes for patients.
From the FDA Drug Label
Nystatin Oral Suspension, USP, is indicated for the treatment of candidiasis in the oral cavity. The recommended dosage of SPORANOX ® (itraconazole) Oral Solution for oropharyngeal candidiasis is 200 mg (20 mL) daily for 1 to 2 weeks.
Treatment Options for oral candidiasis include:
- Nystatin (PO): indicated for the treatment of candidiasis in the oral cavity 2
- Itraconazole (PO): recommended dosage is 200 mg (20 mL) daily for 1 to 2 weeks for oropharyngeal candidiasis 3
From the Research
Treatment Options for Oral Candidiasis
- Topical antifungal agents such as nystatin, miconazole, clotrimazole, and amphotericin B are commonly used to treat oral candidiasis 4, 5, 6, 7, 8
- Systemic antifungal agents like fluconazole, itraconazole, voriconazole, and posaconazole can be used to treat oral candidiasis that does not respond to topical treatment 4, 5, 6, 7, 8
- Echinocandins, such as anidulafungin, caspofungin, and micafungin, can be used to treat invasive candidiasis 4, 5
- Novel approaches, including the use of probiotics, ibrexafungerp, antibodies, cytokines, and antimicrobial peptides, are being explored as potential treatments for oral candidiasis 4, 5
Factors to Consider When Selecting a Treatment
- The type and severity of the oral candidiasis infection 6, 7, 8
- The patient's medical history and any underlying conditions, such as immunosuppression or diabetes 7, 8
- The potential for drug interactions and adverse effects 4, 5, 6, 7, 8
- The patient's ability to tolerate and adhere to the treatment regimen 5, 6