Print Print
CKS is no longer commissioned by the National Institute for Health and Clinical Excellence (NICE). NICE remains committed to providing a replacement service for CKS and is currently reviewing its options. In the meantime, although CKS content is now not being maintained, it still remains relevant and will continue to be made available. CKS content was generated under a programme of topic creation and update. To check if the topic you are viewing is current or out of date, please refer to the topic publication details by clicking on the 'How up-to-date is this topic?' link in the left hand menu on individual topic pages.

Candida - oral - Management
How should I treat oral candidiasis in an otherwise healthy person?

  • For localized or mild oral candidal infection, prescribe topical treatment for 7 days (and advise the person to continue treatment for 2 days after symptoms resolve).
  • For extensive or severe candidiasis, prescribe oral fluconazole 50 mg a day for 7 days.
  • If the infection has not resolved after 7 days, offer treatment for a further week.
    • If there has been some response to miconazole, extend the course for a further week.
    • If miconazole has had little or no effect despite adequate adherence, offer a 7-day course of oral nystatin suspension.
    • If oral fluconazole has not resolved the infection, extend the course for a further week.
  • Advise good dental hygiene and to give up smoking if applicable (see the CKS topic on Smoking cessation).
  • If the person is using an inhaled corticosteroid, provide advice on the prevention of oral candidal infection (see Inhaled corticosteroids).
  • If the person wears dentures, advise about hygiene measures to aid healing and prevent recurrence (see Dentures).
  • If the person has diabetes, review diabetic control and manage accordingly, particularly if there are recurrent episodes of oral candidal infection (see the CKS topic on Diabetes type 2). If the person is taking miconazole or fluconazole with a sulphonylurea drug (for example tolbutamide, glipizide and related drugs):
    • Treatment does not need to be interrupted or monitored.
    • Advise the person to seek medical advice if they have symptoms of hypoglycaemia (for example nervousness, sweating, and/or trembling).
  • The following treatments are not recommended for initiation in primary care:
    • Itraconazole.
    • Ketoconazole.
    • Amphotericin.

© NHS Institute for Innovation and Improvement