8.1 Oropharyngeal Candidiasis
| Type of Infection | First Line (with Dosage and Duration) |
Alternative First Line (with dosage and Duration) |
Comments |
|---|---|---|---|
| Mild | Clotrimazole troches/ lozenges 10mg 4-5 per days for 7 days | Fluconazole 200mg OD for 7-14 days | Common local infection seen in infants, older adults who wear dentures, patients treated with antibiotics, chemotherapy or radiation therapy to the head and neck, and those with cellular immune deficiency like HIV. In cases of denture stomatitis, the patient should refrain from using their denture for at least two weeks. |
| Moderate to severe or immunosuppressed | Fluconazole 100–150 mg (3 mg/kg for children) for 7 to 14 days | Itraconazole 200mg PO daily x7-14 days |
For common etiological agents of Oropharyngeal Candidiasis, see Annexure B.8.1
Additional Information
- Clinicians should avoid prescribing fluconazole in the first trimester of pregnancy.
- When there is no response to fluconazole after 14 days of treatment, consider a higher dose or alternate therapy based on culture sensitivity.
- In addition to the drug treatment, ensure that the patient has adequate hydration and nutrition.
References
1. Guidelines on the Treatment of Skin and Oral HIV-Associated Conditions in Children and Adults. Geneva: World Health Organization; 2014. 12, Evidence and recommendations on oropharyngeal candidiasis. Available from: https://www.ncbi.nlm.nih.gov/books/NBK305416/