Our approach to the management of oral thrush in children ≥12 months

HIV: human immunodeficiency virus; IV: intravenous.
* Nystatin solution should be swished and held in the mouth as long as possible before being swallowed.
¶ Lozenges should not be used in children younger than four years.
Δ IV fluconazole may be warranted for immunocompromised children with thrush and oropharyngeal pain that interferes with eating.
◊ Fluconazole-resistant Candida may be suspected in children who are known to be colonized with a resistant species (eg, Candida glabrata, Candida krusei), children who have been receiving azole antifungal prophylaxis, and children cared for in medical centers with a high proportion of resistant species.
§ Refer to Lexicomp monograph for dosing.