Oropharyngeal candidiasis

[Clin Infect Dis 2009;48:503-35.]

 

- Screen for HIV unless:

  • infant
  • known immunodeficiency/ immunosuppression
  • recent use of inhaled steroids.

- For immunosuppressed patients, fluconazole 200mg/ day is recommended. Maintenance therapy may be necessary.

 
Usual Pathogens

Candida albicans
Occasionally non-albicans spp

 

Empiric Therapy Dose Duration
Nystatin susp 500,000 U (5mL) qid 7-14 days
or    
Clotrimazole vag insert used orally 100mg PO daily 7-14 days

Alternative

Empiric Therapy Dose Duration
Fluconazole 100-200mg (3mg/kg) PO daily 7-14 days

Infants (Thrush)

Empiric Therapy Dose Duration
Nystatin 100,000 U (1mL) qid 7-10 days