When such prophylaxis used (e.g., in very low-birthweight neonates weighing <1 kg in nurseries with high rates of neonatal invasive candidiasis), AAP and IDSA recommend fluconazole.

Antifungal prophylaxis in low-birthweight neonates has been controversial. Oral nystatin (oral suspension) has been used for prophylaxis to reduce the incidence of invasive candidiasis in low-birthweight neonates at high risk †. If primary prophylaxis is used to prevent invasive candidiasis in such patients, a systemic azole antifungal (fluconazole, itraconazole, posaconazole, voriconazole) or echinocandin (caspofungin, micafungin) recommended. Routine primary antifungal prophylaxis against Candida in neutropenic patients not recommended, but may be considered when risk of invasive candidal infection is substantial (e.g., allogeneic hematopoietic stem cell transplant recipients, patients with acute leukemia undergoing intensive remission-induction or salvage-induction chemotherapy). Oral nystatin (oral suspension, tablets) has been used in various regimens for prophylaxis against Candida infections † during periods of iatrogenic neutropenia in patients receiving immunosuppressive therapy (e.g., patients with malignancies, transplant recipients). Prevention of Candidiasis in Transplant Recipients, Cancer Patients, or Other Patients at High Risk Oral treatment of mucous membrane (nonesophageal) GI candidiasis.Įsophageal candidiasis requires treatment with a systemic antifungal (not a topical antifungal). Nonesophageal Mucous Membrane GI Candidiasis For HIV-infected children with uncomplicated oropharyngeal candidiasis, topical treatment with clotrimazole lozenges or nystatin oral suspension recommended oral fluconazole recommended for initial treatment of moderate to severe oropharyngeal candidiasis or when an oral regimen preferred (e.g., in infants).

For moderate to severe oropharyngeal candidiasis, IDSA recommends oral fluconazole.įor HIV-infected adults and adolescents with oropharyngeal candidiasis, CDC, NIH, and HIV Medicine Association of IDSA recommend oral fluconazole as drug of choice if topical treatment used, clotrimazole lozenges, miconazole buccal tablets, or nystatin oral suspension recommended. Topical treatment of candidiasis of the oral cavity (oropharyngeal candidiasis, thrush).įor mild oropharyngeal candidiasis, IDSA recommends topical treatment with clotrimazole lozenges or miconazole buccal tablets nystatin (oral suspension) is a recommended alternative. Although studies have not provided evidence that concomitant topical and oral therapy is more effective than topical therapy alone, some clinicians suggest that such a strategy may be warranted and is reasonable in severe cases or when patient also has candidal oropharyngeal or GI infection. Some clinicians recommend that an oral antifungal (e.g., oral nystatin †, fluconazole) be used concomitantly to treat possible coexisting intestinal infection (e.g., in those with diaper rash and thrush). Usually effectively treated with a topical antifungal (e.g., topical nystatin, miconazole, clotrimazole, ciclopirox). albicans in their intestines and infected feces appear to be an important source of the cutaneous infection however, exact role of GI colonization in development or recurrence of diaper dermatitis unknown. Many infants with candidal diaper dermatitis harbor C. Topical treatment of candidal diaper dermatitis. Topical treatment of cutaneous or mucocutaneous infections (e.g., intertriginous candidiasis, candidal diaper rash) caused by Candida albicans and other susceptible Candida. Written by ASHP.Īntifungal polyene antibiotic.

Cancer nystatin swish esophageal thrush