Oral candidiasis management depends on the clinical picture. Topical antifungal therapy is the standard first-line approach for uncomplicated cases. When a patient is intolerant of or refractory to topical treatment, or is at elevated risk of developing systemic infection, systemic antifungal therapy becomes the appropriate step.
In these circumstances, the protocol combines systemic antifungal therapy with continued topical antifungal therapy — the continuation of topical treatment serves to reduce the overall dose and duration of systemic treatment required. The specific agents, sequencing, and full clinical algorithm are detailed in the structured protocol.
DOI: 10.1136/pmj.78.922.455
Systemic antifungal therapy in oral candidiasis is appropriate in patients intolerant of or refractory to topical treatment and those at high risk of developing systemic infections.
Topical antifungal therapy is the recommended first line treatment for uncomplicated oral candidiasis and where systemic treatment is needed topical therapy should continue as this reduces the dose and duration of systemic treatment required.
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