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Candida - oral - Management
How should I treat oral candidiasis in a child?
- Prescribe topical treatment for 7 days (and advise the person to continue treatment for 2 days after symptoms resolve).
- Offer miconazole oral gel first-line (off-label use in children younger than 4 months of age).
- Offer nystatin suspension (off-label use in neonates) if miconazole oral gel is unsuitable (for example if the child has liver dysfunction or is taking medication extensively metabolized by the liver).
- If the infection has not resolved after 7 days, and:
- There has been some response, extend the course of miconazole oral gel for a further week.
- Miconazole has had little or no effect despite adequate adherence, offer a 7-day course of oral nystatin suspension.
- If the child is using an inhaled corticosteroid, provide advice on the prevention of oral candidal infection (see Inhaled corticosteroids).
- If the child has extensive or severe candidiasis, consider seeking specialist advice.
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