Download Oral Thrush

Oral Thrush
Definition
Description of
symptoms
Criteria for INCLUSION
Criteria for
EXCLUSION
Advice to be given
OTC medication
Oral candidaisis is a fungal infection of the oral mucosa most commonly caused
by Candida albicans, although it can be caused occasionally by other Candida
species
 Red areas under dentures
 White spots on the mouth and tongue. These may join together to form larger
spots or plaques. When wiped off, the underlying tissue may be red and raw.
 After antibiotics or steroids, thrush can appear as just red and sore.
 There may also be red sore areas at the corner of the lips known as angular
cheilitis or angular stomatitis.
 Many mild oral thrush infections are painless, although the condition can
sometimes become quite sore.
 Babies may drool saliva or refuse to feed properly because of the soreness.
(Children: 2-12 years) & (Adults and children over 12 years)
Children < 2 yrs
Patients with hepatic impairment
Diabetic patients (on sulphonylureas)
Patients on Warfarin and Simvastatin (possible interactions)
Any potentially hazardous drug interactions as listed in Appendix 1 of current BNF
 Leaflet
 Encourage appropriate dental hygiene
 Encourage appropriate management of conditions e.g. use of steroid inhalers
or management of blood glucose levels`
Daktarin oral gel 15g
Adults and children over 12 years:
One to two 5 ml spoonfuls QDS after food; retain near lesions before swallowing
6-12 yrs:
One 5ml spoonful QDS after food; retain near lesions before swallowing
2-6 yrs:
One 5ml spoonful BD after food; retain near lesions before swallowing
Frequency of
consultation
Number of products
allowed in one
consultation.
When to refer
Resources and leaflets
The gel should be kept in the mouth for as long as possible.
Treatment should be continued for up to 2 days after the symptoms have cleared.
Dentures should be removed at night and brushed with the gel.
One per month
ONE.
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Lesions that are bleeding or look infected
HIV positive patients
If the patient has got persistent thrush despite treatment
If patient is on a long term course of antibiotics or immunosuppressant drugs
(e.g. azathioprine, methotrexate)
 Thrush not clearing after 7 days of treatment
Conditional referral: consider supply and then sign posting to a dentist
 Patients with ill fitting dentures
CKS topic & patient.co.uk leaflet
Denture stomatitis (British Dental Health Foundation)
For use as guidance in the Pharmacy First Service NHSLC
Updated March 2013
Review March 2014