In fluconazole resistant cases: Itraconazole (200 mg twice daily) can be used with cure rate between 64 - 80%.

Continuous prophylactic fluconazole use is more effective than intermittent use in response to relapses.

In pediatric patients: use itraconazole in a dose of 2.5 mg/kg/day.

Most immunocompromised patients respond initially to topical agents using the same regimen above but relapses occur rapidly unless fluconazole (400 mg [6 mg/kg} daily)is not used.

Medical treatment of oropharyngeal candidiais in immunocompromised patients:.For refractory disease, consider the alternative regimen. Fluconazole is recommended in moderate-to-severe disease, and topical therapy with Clotrimazole or Nystatin is recommended for mild disease. Note: Treat uncomplicated disease for 7вЂ“14 days.Alternative regimen: Itraconazole solution 200 mg PO q24h OR Posaconazole 400 mg PO q24h OR Voriconazole 200 mg PO q24h OR Amphotericin B oral suspension PO q24h OR ( Anidulafungin 200 mg IV once THEN Anidulafungin 100 mg IV q24h) OR ( Caspofungin 70 mg IV once THEN Caspofungin 50 mg IV q24h) OR Micafungin 100 mg IV q24h OR Amphotericin B 0.3 mg/kg IV q24h.Preferred regimen: Clotrimazole troches 10 mg TOP q4-5h OR Nystatin suspension or pastilles TOP q6h OR Fluconazole 100вЂ“200 mg PO q24h.Systemic antifungal medication such as fluconazole or itraconazole may be necessary for oropharyngeal infections that do not respond to these treatments. Oral candidiasis usually responds to topical treatments such as clotrimazole troches and nystatin suspension ( nystatin - swish and swallow). Patients who are immunocompromised, either with HIV/ AIDS or as a result of chemotherapy, may require systemic treatment with oral or intravenous administered antifungals. Oral candidiasis can be treated with topical anti-fungal drugs, such as nystatin (mycostatin), miconazole or amphotericin B. Patients who are immunocompromised, either with HIV/ AIDS or as a result of chemotherapy, may require systemic treatment with oral or intravenous administered antifungals.ДЄny underlying cause, such as poor glucose control in diabetics, should be addressed. Associate Editor(s)-in-Chief: Ahmed Younes M.B.B.CH Overview Risk calculators and risk factors for Oral candidiasis medical therapyД®ditor-In-Chief: C. Oral candidiasis medical therapy in the newsД«logs on Oral candidiasis medical therapyДirections to Hospitals Treating Oral candidiasis Oral candidiasis medical therapy On the WebДЄmerican Roentgen Ray Society Images of Oral candidiasis medical therapyДЄll Images X-rays Echo & Ultrasound CT Images MRI Natural History, Complications and Prognosis Differentiating Oral candidiasis from other Diseases

Swish and swallow nystatin