IDSA Recommendations for Treating Mucosal Candidiasis in HIV-AIDS

Oropharyngeal Candidiasis: Initial Episodes (Duration of Therapy: 7–14 days)

Preferred Therapy:

 • Fluconazole 100 mg PO once daily (AI), or

Alternative Therapy:

 • Clotrimazole troches 10 mg PO 5 times daily (BI), or

 • Miconazole mucoadhesive buccal tablet 50 mg: Apply to mucosal surface over the canine fossa once daily (do  not swallow, chew, or crush tablet). Refer to product label for more detailed application instructions, (BI) or

 • Itraconazole oral solution 200 mg PO daily (BI), or

 • Posaconazole oral suspension 400 mg PO BID for one day, then 400 mg daily (BI), or

 • Nystatin suspension 4–6 mL QID or 1–2 flavored pastilles 4–5 times daily (BII)

Esophageal candidiasis (Duration of Therapy: 14–21 days) Note: Systemic antifungals are required for effective treatment of esophageal candidiasis (AI)

Preferred Therapy:

 • Fluconazole 100 mg (up to 400 mg) PO or IV daily (AI), or

 • Itraconazole oral solution 200 mg PO daily (AI)



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