Treatment for Thrush (Oral Candidiasis) Caused by Vaping

Diagnosis and Treatment

The British Journal of Dermatology recommends nystatin oral suspension 100,000 units four times daily for 1 week, or miconazole oral gel 5-10 mL held in the mouth after food four times daily for 1 week, as first-line treatment for thrush (oral candidiasis) caused by vaping 1
Diagnosis should be confirmed by clinical examination showing white, thick patches on oral mucosa and tongue that can be scraped off, revealing erythematous areas underneath, as suggested by Clinical Infectious Diseases 2

Nystatin oral suspension is recommended at 100,000 units (4-6 mL) four times daily for 7-14 days, according to Clinical Infectious Diseases and British Journal of Dermatology 1, 2
Miconazole oral gel is recommended at 5-10 mL held in the mouth after food four times daily for 7 days, as suggested by British Journal of Dermatology 1
Clotrimazole troches are recommended at 10 mg troche dissolved in the mouth 5 times daily for 7-14 days, according to Clinical Infectious Diseases 2, 3

Rinsing the mouth with warm saline several times daily can help cleanse the oral cavity, as recommended by Thorax and British Journal of Dermatology 1, 4
Using antiseptic oral rinses, such as 0.2% chlorhexidine digluconate mouthwash or 1.5% hydrogen peroxide mouthwash, twice daily can reduce bacterial colonization, as suggested by British Journal of Dermatology 1
Cleaning and disinfecting any dentures thoroughly can prevent recolonization, according to Clinical Infectious Diseases 3

For fluconazole-resistant cases, itraconazole solution at higher doses (>200 mg/day) may be considered, as recommended by Clinical Infectious Diseases 3
Amphotericin B oral suspension (1 mL four times daily of 100 mg/mL suspension) may be effective in patients who don't respond to azoles, according to Clinical Infectious Diseases 3

Evaluating response to treatment after 7-14 days is recommended, as suggested by Clinical Infectious Diseases 2
Maintaining good oral hygiene can prevent recurrence, according to British Journal of Dermatology 1
Rinsing the mouth after using inhaled medications can also prevent recurrence, as recommended by Thorax 4

Patients with HIV or immunocompromised status may require longer treatment courses and more aggressive management, according to Clinical Infectious Diseases 2
For denture wearers, removing dentures at night and thoroughly cleaning them can prevent recolonization, as suggested by Clinical Infectious Diseases 3
Considering the possibility of non-albicans Candida species, which may be less responsive to standard treatments, is important, according to Clinical Infectious Diseases 2