From the Guidelines
The treatment of oral candidiasis, a fungal infection in the mouth, involves the use of antifungal medications.
Treatment Options
- For mild disease, topical agents such as clotrimazole troches (10mg) or nystatin oral suspension (100,000 units/mL) are recommended, administered 4-5 times daily for 7-14 days 1.
- In more severe cases, systemic antifungals like fluconazole (100-200mg) may be prescribed, taken orally once daily for 7-14 days 1.
Additional Considerations
- Good oral hygiene practices and removal of any offending factors, such as dentures, are essential for effective treatment and prevention of recurrence 1.
- For fluconazole-refractory disease, alternative treatments such as itraconazole solution or posaconazole suspension may be considered 1.
- In cases of refractory disease, intravenous antifungals like amphotericin B or echinocandins may be used as a last resort 1.
- Antiretroviral therapy should be used whenever possible for HIV-infected patients with oral candidiasis to reduce the frequency of recurrent infections 1.
From the FDA Drug Label
Nystatin Oral Suspension, USP, is indicated for the treatment of candidiasis in the oral cavity. The treatment for oral candidiasis (fungal infection in the mouth) is nystatin.
- The specific dosage is not provided in the given text, but nystatin oral suspension is indicated for this condition 2.
- Fluconazole may also be used to treat oropharyngeal candidiasis, with a recommended dosage of 200 mg on the first day, followed by 100 mg once daily, for at least 2 weeks 3.
- Clotrimazole is another option, with concentrations sufficient to inhibit most species of Candida persisting in saliva for up to three hours following administration 4.
From the Research
Treatment Options for Oral Candidiasis
The treatment for oral candidiasis, a fungal infection in the mouth, can be managed through various methods, including:
- Topical antifungal agents, such as nystatin, clotrimazole, and ketoconazole, which can be used as rinses, pastilles, or lozenges 5
- Systemic antifungal medications, such as fluconazole, which can be used to treat more resistant forms of oral candidiasis 6
- Disinfecting solutions, such as chlorhexidine gluconate or hydrogen peroxide, which can be used to clean dental prostheses and oral hygiene aids 7
Topical Antifungal Agents
Topical antifungal agents are not absorbed when given orally and act by direct contact on the fungus 8. These agents include:
- Polyens, such as amphotericin B or nystatin
- Azoles, such as clotrimazole or miconazole
- Allylamine and morpholine
- Antiseptic substances
Systemic Antifungal Agents
Systemic antifungal agents are indicated in cases of poor compliance to topical agents, prophylaxis of highly relapsing disease, oesophageal candidiasis, and Candida onychomycosis 8. These agents include:
- Fluconazole, which has been shown to be effective in treating oral candidiasis in high-risk patients 6
- Ketoconazole, which can be used systemically to treat oral candidiasis, but may cause adverse liver changes 5
Additional Considerations
In addition to antifungal treatment, it is also important to:
- Identify and eradicate predisposing factors, such as local or systemic factors that may be contributing to the infection 5, 7
- Manage the infection in association with appropriate medical specialists, especially in cases of deep fungal infections or systemic involvement 7
- Consider the use of herbal plant-derived compounds with antifungal activity, which may be used in combination with traditional antifungal drugs to reduce the risk of drug resistance 9