Fungal Infections

Question 1

Patient groups that are predisposed to pseudomembranous candidosis and erythematous candidosis infections ?

Answer 1

Patients taking inhaled corticosteroids

Cytotoxics or broad-spectrum antibacterials

Diabetic patients

Patients with nutritional deficiencies

Patients with serious systemic disease associated with reduced immunity such as leukaemia

Other malignancies

HIV infection

Question 2

Three drugs indicated in the treatment of pseudomembrane candidosis and erythematous candidosis

Answer 2

1. Flucanazole
2. Miconazole
3. Nystatin

Question 3

Flucanazole - pseudomembran candidosis, denture stomatitis

Answer 3

Fluconazole Capsules, 50 mg
Send: 7 capsules
Label: 1 capsule daily

For children:

Fluconazole Capsules 50 mg or Oral Suspension, 50 mg/5 ml

6 months - 12 years 3-6 mg/kg on first day and
then 3 mg/kg (max. 50 mg) daily
12-18 years 50 mg daily

Question 4

Miconazole for pseudomembrane candidosis

denture stomatitis

Answer 4

Micanazole Oromucosal Gel, 24 mg/ml
Send: 80 g tube
Label: Apply a pea-sized amount after food four times daily

For children:

Miconazole Oromucosal Gel*, 24 mg/ml
2-6 years Apply a pea-sized amount twice daily after food
6-18 years Apply a pea sized amount four times daily after food

Question 5

Nystatin for pseudomembran candidosis

denture stomatitis

Answer 5

Nystatin Oral Suspension, 100,000units/ml
Send: 30 ml
Label: 1 ml after food four times daily for7 days

Question 6

Initial treatment of angular chelitis

Answer 6

Miconazole Cream, 2%
Send: 20 g tube
Label: Apply to angles of mouth twice daily

Sodium Fusidate Ointment, 2%
Send: 15 g tube
Label: Apply to angles of mouth four times daily

Miconazole cream is effective against both Candida and Gram-positive cocci and is therefore appropriate to use for all patients. Where the condition is clearly fungal in nature nystatin ointment can be used and where it is bacterial in nature sodium fusidate (fusidic acid) ointment can be used.

Question 7

Treatmetn of angula chelitis when un responsive to intial treatment.

Answer 7

Miconazole (2%) and Hydrocortisone (1%) Cream
Send: 30 g tube
Label: Apply to angles of mouth twice daily

Miconazole (2%) and Hydrocortisone (1%) Ointment
Send: 30 g tube
Label: Apply to angles of mouth twice daily

A lack of clinical response might indicate
predisposing factors such as a concurrent haematinic deficiency or diabetes. Refer such cases to
a specialist or the patient’s general medical practitioner.