Medications

Prescription medicines that inhibit the growth of yeast (antifungals) are used to treat thrush.

In infants, treatment is continued for at least 48 hours after the symptoms have gone away. Most adults need treatment for 14 days. In more severe or persistent infections, treatment may be continued beyond the normal treatment period.

Antifungal medicines are either applied directly to the affected area (topical) so the medicine affects only that area, or swallowed (oral) so the medicine affects the entire body. In rare cases, an antifungal medicine will need to be injected into a vein (intravenous, or IV).

Topical antifungal medicines

Topical antifungal medicines are applied to the affected area and are available in several forms, such as rinses and lozenges.

Topical antifungal medicines need to be in contact with the affected area long enough to stop the growth of the yeast. Lozenges are preferred because they take longer to dissolve. Because the lozenges need moisture to dissolve, sipping water while using them may help them work better.

Because several of the topical antifungal medicines contain sugar, there is an increased risk of cavities when the medicines are used for long periods of time. Using a topical fluoride rinse or gel (if you are not already obtaining fluoride through other means) during treatment may help prevent cavities. Talk to your doctor or dentist before you give your child fluoride products. Too much fluoride may be toxic and can stain a child's teeth.

Oral antifungal medicines (pills)

Unlike topical antifungal medicines, oral antifungal medicines affect the whole body. Oral medicines are used alone to treat mild thrush infections. But oral medicines also may be combined with topical antifungal medicines to treat more severe thrush infections.

Oral antifungal medicines are used to prevent thrush in certain people with conditions that weaken the body's immune system.

Oral antifungal medicines should not be used during pregnancy because the fetus may be harmed. But oral antifungal medicines may be used in pregnant women who have a rare, severe infection.

Medication Choices

• Polyenes (such as nystatin)
• Azoles (such as clotrimazole, fluconazole, and itraconazole)
• Chlorhexidine
• Gentian violet (1%), an over-the counter dye that kills bacteria and fungi, including the yeast that causes thrush

What to Think About

• Both polyenes and azoles cure thrush most of the time.
• An azole or nystatin is usually the first medicine used to treat thrush in children.¹
• If thrush does not respond to medicines, your doctor may do a culture test to find out whether drug-resistant strains of yeast are causing the infection.