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Oral Thrush (cont.)

How Is Oral Thrush Treated?

Two broad categories of therapy exist to treat oral thrush -- a traditional medical approach and a homeopathic approach. Traditional medications may either be topically applied (for example, nystatin, 1% gentian violet) or ingested in liquid form (for example, fluconazole [Diflucan]). Nystatin is generally applied four times a day for approximately five to seven days. One study (treating HIV/AIDS patients) demonstrated a cure rate of 52% (vs. 87% when employing fluconazole; the immune-compromised status of the study population may have affected outcomes). When treating infants and toddlers, application using a small gauze or Q-tip is more effective than just drinking the preparation. Most pediatricians will elect topical nystatin in lieu of oral medications for ease of administration, reserving the use of fluconazole for treatment failures; 1% gentian violet is rarely used due to the long-lasting bright purple stain it makes in the mouth or on clothing/bed linen.

Fluconazole is a once-a-day preparation that is used for 14 days. Primary side effects are few (5% or less) and generally intestinal in nature (upset stomach, vomiting, and/or diarrhea). It is rare that such side effects necessitate discontinuation of the medication. Relapse rates (return of symptoms after apparently successful therapy) are less with fluconazole when compared to nystatin.

Regardless of which approach is used, application of the medication to baby bottle nipples, pacifiers, or the nipples of breastfeeding mothers is felt to increase the rate of success of therapy by lessening the likelihood of reintroduction of Candida to the infant.

Medically Reviewed by a Doctor on 4/6/2016

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