Fungal infection

Question 1

Oral thrush

Answer 1

1st line = miconazole (daktarin) gel
2nd line = nystatin
Extensive/severe = oral fluconazole

Question 2

Vaginal thrush

Answer 2

Caused by candida albicans
1st line = oral azole (fluconazole or itraconazole)
2nd line = intravaginal imidazole pessary or cream (clotrimazole)
Topical antifungal cream can be used to treat superficial symptoms.

Question 3

Intravaginal pessary

Answer 3

Local irritation may occur - can be mistaken for treatment failure
Can repeat after 7 days if no improvement

Question 4

Pregnancy

Answer 4

DO NOT give oral azoles
Treatment with intravaginal pessaries - longer duration of treatment (7 days) may eb required.
Counsel pt not to use applicator

Question 5

Tinea capatis, corporis, cruris and pedis

Answer 5

Miconazole or Clotrimazole or Terbinafine (althetes foot)

Question 6

Fungal nail infection (Tinea ungium)

Answer 6

Amorolfine 5% nail lacquer