Treatment strategies for oropharyngeal candidiasis

Abstract

Background: Oropharyngeal candidiasis (OPC) is a common oral disease that may cause oral symptoms, lead to regional infection (e.g., esophageal candidiasis) and increase the risk of systemic fungal infection in the compromised host. Objective: Critical review of the literature of prevention and therapy. Methods: The literature was reviewed using PubMed, and specific keywords from the MeSH Database were used. Results/conclusion: Management of OPC requires that the underlying risk factors of infection be diagnosed and managed whenever possible. Antimicrobials may be provided as topical or systemic therapy. Topical therapies may provide effective management for candidiasis in the non-compromised host and increase the control of colonization in the compromised host. Advances in prevention and management include new agents and improved mechanisms of topical drug delivery.

Keywords::

• administration
• anti-infective agents
• azoles
• candidiasis
• chronic mucocutaneous
• disease management
• drug therapy
• echinocandins
• oral candidiasis
• oropharyngeal candidiasis
• polyenes
• topical antifungal agents

Addendum

Since this manuscript was accepted for publication, 2 documents of considerable interest have been published. Readers are strongly encouraged to review these new documents for current guidelines, indications and dosing regimens related to the treatment of OPC.

Pappas PG, Kauffman CA, Andes D, et al. Clinical practice guidelines for the management of candidiasis: 2009 update by the Infectious Diseases Society of America. Clin Infect Dis 2009 March 1;48(5):503-35 2. Food and Drug Administration (FDA) Revisions to Package Insert of posaconazole. Available from: http://www.fda.gov/cder/foi/appletter/2009/022003s007ltr.pdf [Cited 19 February 2009]