Antifungal and Antiviral Therapy

Antifungal Medication	How to Prescribe
Nystatin 100,000 U/mL ^a	Dispense 300 mL; swish and spit out (or swallow) 5 mL 3–4 times a day for 7–10 days
Nystatin pastilles 200,000 U/pastille	Dissolve 1–2 pastilles in mouth 3–4 times a day for 7–10 days
Amphotericin B suspension 100 mg/mL	Dispense 300 mL; swish and spit out 5 mL 3–4 times a day for 7–10 days
Amphotericin 10-mg lozenges	Dissolve 1–2 tablets in mouth 3–4 times a day for 7–10 days
Clotrimazole 10-mg troches ^a	Suck on one troche 3–5 times a day for 7–10 days (troches do not dissolve if there is prominent hyposalivation)
Ketoconazole 200–400 mg daily	Take 1 or 2 tablets twice a day for 7–10 days
Miconazole 50 mg dissolving tablets daily	Dissolve in mouth once a day for 7–10 days
Fluconazole 100–200 mg daily Itraconazole 100–200 mg daily Voriconazole 200 mg twice a day Posaconazole 100 mg daily	Fluconazole: Use as directed for 3–4 days (depending on the severity of the infection); long-term therapy may lead to resistance to fluconazole. Culture and sensitivity should be performed, and itraconazole, voriconazole, and posaconazole are alternatives; may be taken 1–2 times a week for prophylaxis if on long-term immunosuppressive therapy.
Mycostatin/triamcinolone cream Clotrimazole/betamethasone cream Iodoquinol/hydrocortisone 1% cream Miconazole 2% gel Miconazole/hydrocortisone	Apply to corners of mouth 3–4 times a day or for angular cheilitis Paint onto denture base 3 times a day and wear denture; add erythromycin gel if there is residual lesion, because Staphylococcus aureus may be involved.
*Denture soaks:* Nystatin 100,000 U/mL Chlorhexidine digluconate 0.12–2% 3% sodium hypochlorite diluted in water (1 : 10) 2% sodium benzoate	Soak denture in solution overnight. Dentures should never be worn overnight.