Oral candidiasis Flashcards
(19 cards)
What type of organism is Candida?
A yeast-like fungus, part of normal GI flora.
Name 3 common types of oral candidiasis.
Pseudomembranous candidiasis, denture stomatitis, chronic plaque-like candidiasis.
Chronic plaque-like candidiasis - may carry a risk of malignancy.
Name 4 risk factors for oral candidiasis.
Immunosuppression (e.g. HIV), diabetes, antibiotic use, poor oral hygiene.
What is first-line treatment for oral candidiasis in immunocompetent adults?
Topical antifungal (miconazole oral gel).
When should nystatin be used instead of miconazole?
If miconazole is unsuitable or contraindicated.
How long should topical antifungal treatment be continued?
For 7 days after symptoms resolve.
How long should dentures be removed daily to promote healing?
At least 6 hours.
What should you advise patients using inhaled corticosteroids?
Rinse mouth, brush teeth, use spacer, and consider stepping down dose.
What is the oral fluconazole regimen for adults ≥16 with severe/refractory candidiasis?
200–400 mg on day 1, then 100–200 mg daily for 7–21 days.
When should liver function be monitored with fluconazole?
If treatment exceeds 21 days.
What steps should be taken if oral fluconazole fails?
Extend treatment, swab for culture, consider resistance, refer if needed.
What is first-line treatment in children ≥4 months old?
Miconazole oral gel (off-label use in younger infants).
What is the first-line treatment for oral candidiasis in HIV-positive adults?
Fluconazole 200–400 mg on day 1, then 100–200 mg daily for 7–14 days.
Name 2 drug interactions to be aware in immunocompromised patients.
Sulphonylureas (e.g. gliclazide) and warfarin with miconazole/fluconazole.
How should miconazole oral gel be used?
Apply 4 times daily after food, continue for 7 days after symptoms resolve.
What key drug interactions should be checked before prescribing miconazole?
Warfarin (↑ bleeding risk), statins (↑ statin levels), sulfonylureas like gliclazide (↑ hypoglycaemia risk).
What is the typical regimen for nystatin oral suspension?
Use 4 times daily; continue for at least 48 hours after lesions resolve.
What is a benefit of nystatin regarding drug interactions?
It is not systemically absorbed, so has fewer interactions.
What is the standard adult fluconazole dosing for oral candidiasis?
200–400 mg on day 1, then 100–200 mg once daily for 7–14 days.
