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Candida - oral - Management
Basis for recommendation
- Follow up for all people is a pragmatic recommendation, and reflects what CKS considers to be good clinical practice. Oral candidal infection is a serious cause or morbidity and mortality in people who are immunosuppressed, and it is reasonable to ensure treatment has been satisfactory and complications have not developed.
- CKS found no clinical data on which to base decisions if initial treatment is not fully effective in people receiving concomitant immunosuppressive drugs.
- Extending treatment, or switching to nystatin (which may be effective against resistant organisms) or oral fluconazole (which has a systemic effect) are reasonable options before expert advice or referral are sought, provided deterioration has not occurred [Samaranayake et al, 2009].
- The dose of fluconazole may also be increased in unusually difficult candidal infections [BNF 57, 2009].
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