From the Guidelines
Fluconazole treatment for oral candidiasis (oral thrush) should last for 14-21 days. The recommended dosage is 200-400 mg (3-6 mg/kg) daily, as stated in the clinical practice guideline for the management of candidiasis: 2016 update by the Infectious Diseases Society of America 1. This guideline provides strong recommendations based on high-quality evidence.
Key Points to Consider
- The treatment duration may vary depending on the severity of the infection and the patient's response to therapy.
- For patients who cannot tolerate oral therapy, alternative treatments such as intravenous fluconazole or an echinocandin may be considered 1.
- It is essential to complete the full course of treatment, even if symptoms improve earlier, to prevent recurrence.
- Patients with recurrent infections may need to address underlying factors such as immunosuppression, diabetes, or continued use of inhaled corticosteroids without proper mouth rinsing.
Treatment Recommendations
- Oral fluconazole, 200-400 mg (3-6 mg/kg) daily, for 14-21 days is the recommended treatment for oral candidiasis (oral thrush) 1.
- For fluconazole-refractory disease, alternative treatments such as itraconazole solution or voriconazole may be considered 1.
- Chronic suppressive therapy with fluconazole, 100-200 mg 3 times weekly, may be recommended for patients with recurrent esophagitis 1.
From the Research
Duration of Treatment with Fluconazole for Oral Candidiasis
- The duration of treatment with fluconazole for oral candidiasis (oral thrush) varies depending on the study and patient population.
- In a study published in 1998, fluconazole was administered at a dose of 100 mg/day for 14 days 2.
- Another study from 1991 used fluconazole at a dose of 50 to 100 mg/day for a period of 8 to 22 days 3.
- A 2008 study compared a single 750-mg dose of fluconazole to a 14-day course of 150 mg/day and found both regimens to be effective 4.
- A 2017 study used a single-dose of 150 mg of fluconazole and found it to be effective in treating oral thrush in hospice and palliative medicine patients 5.
- A 1998 study compared itraconazole oral solution to fluconazole capsules and used fluconazole at a dose of 100 mg once daily for 14 days 6.