Management of oral and oropharyngeal candidiasis in neonates and children
For neonates and children with oral or oropharyngeal candidiasis, management involves treating the concomitant cutaneous candidiasis (eg diaper rash, nipple thrush in the mother), as well as the oral or oropharyngeal candidiasisMekkes, 2022.
For neonates with oral or oropharyngeal candidiasis, use:
1nystatin 100 000 units/mL liquid 1 mL topically (then swallowed), 4 times daily after feeding, usually for 7 days1. Continue for 2 days after symptoms have resolved. Apply with a cotton bud or a clean or gloved finger all over the inside of the mouth nystatin
OR
2miconazole 2% gel 1 mL topically (then swallowed), 2 to 4 times daily after feeding, for 7 to 14 days as guided by symptom resolution. Apply with a cotton bud or a clean or gloved finger inside the front of the mouth2. miconazole
For children with oral or oropharyngeal candidiasis, use:
1miconazole 2% gel 1.25 mL topically (then swallowed), 4 times daily after food and drink, for 7 to 14 days as guided by symptom resolution. Place directly in the mouth and on the tongue2 miconazole
OR
1nystatin 100 000 units/mL liquid 1 mL topically (then swallowed), 4 times daily after food and drink, usually for 7 days1. Continue for 2 days after symptoms have resolved. Place under tongue or in buccal cavity. nystatin
Successful treatment relies on adequate contact time between the antifungal and the affected mucosa – ensure neonates do not feed, and children do not eat or drink, directly after administration. If neonates or children do not respond to topical antifungal therapy, seek expert advice.