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I know you cannot diagnose anyone by not being able to see them in person. But I have quick question about Thrush. I have this off white gunk I get in the back of my mouth. Its in the grooves of the arch way right before my throat starts. Its not painful or burning and it comes and goes during the day.Some days I have more and others I barely have any. I told my doctor about it via a phone call and she prescribed me Nystatin Oral Suspension. It has done nothing to rid my mouth of the plaquish looking stuff.She had me on 5mls , 4 times a day. Does this even sound like a case of Thrush, should the doctor consider a different diagnosis.Does thrush kind of come and go depending on what you eat that day? I also hear alot of people say Nystatin doesnt work very well.What is your opinion? Please try to answer this as it is very frustrating.
Thank you
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Response from Dr. Reznik
You are correct that I cannot determine the nature of your problem without having the ability to perform an examination, but I do have some thoughts concerning Nystatin oral suspension:
This is a relatively weak topical antifungal mouthrinse, which has a very high sugar content and must be kept in contact with the affected areas for 5 minutes, 4 times a day for two weeks. Looking at past studies comparing the efficacy of Nystatin suspension, it appears to be effective approximately 50% of the time. I do not prescribe Nystatin oral suspension.
Since the affected areas are in the posterior portion of your mouth, I would suggest using Diflucan (fluconazole) 200 mg on day one, then 100 mg a day for the rest of the two-week treatment period. If you are experiencing oral candidiasis, this medication should relieve and signs and symptoms.
Take care,
DR
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Response from Dr. Reznik
