Oral Candidiasis

Topical azoles more effective than topical nystatin. Oral candidiasis rare in immunocompetent adults; consider undiagnosed risk factors including HIV.

If HIV or immunosuppression use 100mg fluconazole.

NB: Significant drug interactions with fluconazole and miconazole – check BNF/SPC

Miconazole oral gel 20mg/mL

2.5 mL four times daily after food

Continue for 7 days after lesions resolve

nystatin suspension 100,000 units/mL 

1 mL four times daily after food

7 days or until 2 days after symptoms resolve

OR

Fluconazole

50mg once daily (100mg if immunosuppressed)

3-7 days