Question

What is thrush and what causes it? What medication is used to treat thrush?

Answer

Thrush is a common term for pseudomembranous candidiasis which is caused by fungal organisms. The most common causative agent is Candida albicans, but our recent research has shown an increased prevalence of non-albicans species such as Candida glabrata and Candida Krusei. The difficulties these non-albicans species bring is that, for the most part, they do not respond to existing therapies.

Medications used to treat thrush are based on the extent of disease. For mild to moderate infections, I recommend topical therapies such as Mycelex troches. I do not recommend the use of nystatin swish and swallow due to the high glucose concentration (50%) as well as the length of time a person in expected to keep this medication in the mouth (5 minutes). This is the time nystatin needs to be in contact with the candidal plaques to be effective.

For moderate to severe bouts of thrush I recommend Diflucan (fluconazole) which is dosed a 200 mg on day one, then 100 mg a day for the rest of a two week period of time.

Whether you are using a topical or systemic medication, treatment should last for at least two weeks; this helps prevent against recurrence of the infection. For pictures of candidiasis, please visit the HIVdent Picture Gallery.

I hope his information proves helpful.

Sincerely,

DR