Oral Thrush

Micro-organism

Candida albicans

Notes
  • Send scrapings for culture
  • Caution: significant drug interactions with fluconazole and miconazole - refer to BNF
  • Consider immune deficiency and testing for HIV
First line

Nystatin oral suspension, use 1ml as a mouthwash (then swallow) 6 hourly - usually for 7 days

OR

Fluconazole 50mg oral once daily for 3 - 7 days

Continued for 48 hours after lesions have resolved

 

Immunocompromised:

Fluconazole 100mg oral once daily for 7 - 14 days

OR

if interactions with other medication use nystatin

Second line

Miconazole oral gel, 2.5ml 6 hourly after food - continue for 7 days after lesions resolve.

(NB: interaction with warfarin)