Pseudomembranous Candidosis andErythematous Candidosis

If drug treatment is required, an appropriate 7-day regimen is a choice of:

Fluconazole Capsules, 50 mgSend: 7 capsulesLabel: 1 capsule daily

For children:Fluconazole Capsules 50 mg orOral Suspension, 50 mg/5 ml6 months - 12 years 3-6 mg/kgon first day andthen 3 mg/kg(max. 50 mg) daily12-18 years 50 mg daily

NB: Fluconazole can be administered for a maximum of 14 days for the treatment of oropharyngeal candidosis.Do not prescribe fluconazole for patients taking warfarin or statins

Miconazole Oromucosal Gel*,24 mg/mlSend: 80 g tubeLabel: Apply a pea-sized amount afterfood four times daily

For children:Miconazole Oromucosal Gel*,24 mg/ml2-6 years Apply a pea-sizedamount twice dailyafter food6-18 years Apply a pea sizedamount fourtimes daily after food

NB: Advise patient to continue use for 48 hours after lesions have healed.Do not prescribe miconazole for patients taking warfarin or statins.*Sugar-free preparation is available

If fluconazole and miconazole are contraindicated, an appropriate regimen is:

Nystatin Oral Suspension, 100,000units/mlSend: 30 mlLabel: 1 ml after food four times daily for7 days

For children:As for adults

NB: Advise patient to rinse suspension around mouth and then retain suspension near lesion for 5 minutes beforeswallowing.Advise patient to continue use for 48 hours after lesions have healed

2. Candidoza

Rp: Nistatin suspensie 100.000 u/ml

Sinonime: Micostatin

Prezentare: flacoane cu 6 g de pulbere pt suspensie orală (24 doze de 100.000)

- copii mici:125 ml (doza:200.000 u/zi)

- copil/adult:300 ml (doza copil/adult:500.000 u/zi)

Aplicare:

- copil mic: 2 ml /zi . Se badijonează ţ. orale şi se înghite

- copil/adult:5 ml/zi. Se badijonează 2 min. ţ. orale şi se înghite

Categorie: Antifungic

Efecte secundare: greaţă, vomă, diaree, dermatită de contact

Rp: Fluconazol suspensie 40 mg/ml (toxic)

sau

Fluconazol tablete 100 mg (Diflucan)

Doză:6 mg/kg doză de atac, apoi 3 mg/kg/zi x 13 zile

Administrare: 1 doză/zi x 14 zile

Categorie: Antifungic

Indicaţii: pacienţi imunocompromişi la care nu merge tratamentul cu Nistatină

Contraindicaţii: Nu la pacienţii cu disfuncţie renală/hepatică

Igienizarea cavitatii bucale :clatiri cu CHx, ceai de musetel cu bicarbonat.

Micostatin, Nistatin, Stamicin : suspensi pt clatit, tablete de supt, pomada pt lez cutanate

Candidiasis is the most frequently occurring opportunistic fungal infection toaffect humans. Whereas most cases are caused by Candida albicans, otherspecies have been implicated, especially in immunosuppressed patients. Candidaalbicans is ubiquitous, as evidenced by its ability to exist in a commensalstate in such areas as the skin and the gastrointestinal and genitourinary tracts.In the oral cavity, carriage rates of up to 75% have been reported. The shiftfrom a state of commensalism to a pathogenic infection is almost always associatedwith an underlying predisposing factor. Established predisposing factorsinclude immunosuppression, immunologic immaturity, certain medications, salivarychanges, malignancies, numerous endocrinopathies, epithelial alterations,nutritional deficiencies, high-carbohydrate diet, poor oral hygiene, dentalprostheses, advanced age, and smoking.DiagnosisIn most cases, the diagnosis of oral candidiasis is based on clinical signsand symptoms. For equivocal cases, exfoliative cytology, culture, or biopsy maybe necessary. Because many patients carry C. albicans in a commensal state,the presence of hyphae is usually required to confirm infection when usingcytology. Patients with oral candidiasis may be asymptomatic or complain ofa burning sensation, dysgeusia, or dysphagia. Oral candidiasis may manifesta variety of clinical presentations.Pseudomembranous candidiasis is characterized by the presence ofcreamy, white, curdled milk–like papules or plaques on the mucosal tissues,most commonly affecting buccal and labial mucosa, palate, tongue, and oropharynx

(see Insert, Figure 5-6). These lesions may be wiped away to exposean underlying erythematous base.Erythematous candidiasis (atrophic) manifests as red patches, most commonlynoted on the tongue dorsum or palate (see Insert, Figure 5-7). A burningsensation is often related by the patient. Erythematous candidiasis may occurin a patient wearing a dental prosthesis, in which case the erythema is usuallylimited to the denture-bearing surface.Chronic hyperplastic candidiasis presents as white papules or plaques,most commonly affecting the buccal mucosa or tongue (see Insert, Figure5-8). This variant cannot be easily wiped and represents the least commonlyobserved form.

FLUCONAZOL LPH 50 mg capsulePROSPECTUL PRODUSULUI DENUMIRE: APHTAPLUS pentru tratamentul aftelor şi leziunilor bucale.PREZENTARE: 1 tub a 10 ml