Candidiasis

Prevention

You can prevent most Candida infections by keeping your skin clean and dry, by using antibiotics only as your doctor directs, and by following a healthy lifestyle with proper nutrition. People with diabetes should try to keep their blood sugar under tight control.

If you have HIV or another cause of recurrent episodes of thrush, antifungal drugs such as clotrimazole (Lotrimin, Mycelex) can help to minimize flares.

Treatment

Treatment of candidiasis varies, depending on the area affected:

• Thrush - Doctors treat thrush with topical, antifungal medications such as nystatin (Mycostatin and others) and clotrimazole. For mild cases of thrush, a suspension of nystatin can be swished in the mouth and swallowed, or a clotrimazole lozenge can be dissolved in the mouth. For more severe cases, ketoconazole (Nizoral) or fluconazole (Diflucan) can be taken once a day by mouth.

• Esophagitis - Candida esophagitis is treated with ketoconazole, itraconazole (Sporanox) or fluconazole (most effective medication in patients with HIV/AIDS).

• Cutaneous candidiasis - This skin infection can be effectively treated with a variety of antifungal powders and creams. The affected area must also be kept clean and dry and protected from chafing.

• Vaginal yeast infections - Vaginal yeast infections can be treated with antifungal medications that are administered directly into the vagina as tablets, creams, ointments or suppositories. These medications include butoconazole (Femstat), clotrimazole (Gyne-Lotrimin), miconazole (Monistat 3 and others), nystatin (Mycostatin and others), tioconazole (Trosyd) and terconazole (Vagistat-1). A single dose of oral fluconazole also can be used, although this treatment is not recommended during pregnancy. Sex partners usually do not need to be treated.

• Deep candidiasis - This infection is usually treated with intravenous amphotericin B (Abelcet) or fluconazole.