From the Guidelines
Yes, you should consider changing antibiotics for a 13-month-old with thrush from amoxicillin. Thrush (oral candidiasis) is a common side effect of antibiotics, particularly in young children, as antibiotics disrupt the normal oral flora allowing for overgrowth of Candida species [ 1 ]. If the bacterial infection being treated is responding well, you could switch to a narrower-spectrum antibiotic less likely to cause fungal overgrowth.
Treatment Options
- Alongside changing the antibiotic, treat the thrush with nystatin oral suspension, as recommended by the Infectious Diseases Society of America [ 1 ].
- Ensure the caregiver applies the antifungal medication properly by swabbing it around the mouth rather than just having the child swallow it.
- Also recommend good oral hygiene and sterilization of pacifiers, bottles, or toys that go in the mouth to prevent reinfection.
Key Considerations
- The choice of antibiotic should be based on the specific bacterial infection being treated and its susceptibility to different antibiotics.
- It is essential to monitor the child's response to the new antibiotic and antifungal treatment to ensure that the infections are resolving [ 1 ].
Antifungal Treatment
- For severe or persistent thrush, fluconazole oral suspension may be needed, as it is an effective treatment option for oropharyngeal candidiasis [ 1 ].
From the Research
Thrush and Antibiotics
- A 13-month-old child has developed thrush after taking amoxicillin, which is a common antibiotic used to treat various bacterial infections.
- The development of thrush, a fungal infection, may be a side effect of the antibiotic treatment, as it can disrupt the balance of normal flora in the body.
Alternative Antibiotics
- Studies have shown that alternative antibiotics such as azithromycin and clarithromycin may be effective in treating certain infections while minimizing the risk of developing thrush or other fungal infections 2, 3, 4.
- These antibiotics have been found to have improved tolerability and fewer gastrointestinal adverse effects compared to traditional macrolides like erythromycin 3, 5.
Considerations for Changing Antibiotics
- When considering changing antibiotics, it is essential to weigh the potential benefits and risks of each option, including the risk of developing thrush or other fungal infections.
- The choice of antibiotic should be based on the specific infection being treated, as well as the individual patient's medical history and other factors 5.
- It is also important to note that some antibiotics, such as clarithromycin, may alter the vaginal flora, potentially increasing the risk of urinary tract infections and vaginal candidiasis in women 6.
Potential Next Steps
- Consult with a healthcare professional to determine the best course of action for the child's specific situation.
- Discuss the potential risks and benefits of changing antibiotics, as well as any other treatment options that may be available.