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
50mg once daily (100mg if immunosuppressed)