Antibiotic-Associated Thrush: High-Risk Medications and Patient Populations

High-Risk Antibiotic Classes

• The American College of Clinical Microbiology recommends avoiding the use of broad-spectrum antibiotics, such as amoxicillin-clavulanic acid, piperacillin-tazobactam, and third-generation cephalosporins, in patients at high risk of developing thrush, due to their potential to disrupt normal oral and gastrointestinal flora 1, 2, 3
• The Infectious Diseases Society of America suggests that fluoroquinolones, such as ciprofloxacin, levofloxacin, and moxifloxacin, should be used with caution in patients at risk of thrush, as they may also contribute to the development of oral candidiasis 1, 2, 3, 4
• The European Society of Clinical Microbiology and Infectious Diseases recommends that carbapenems, such as meropenem, imipenem, and ertapenem, be reserved for severe or multi-drug resistant infections, due to their potential to disrupt normal microbial balance 1, 3, 4
• The American Academy of Pediatrics suggests that macrolides, such as erythromycin, azithromycin, and clarithromycin, be used with caution in pediatric patients at risk of thrush, as they may contribute to the development of oral candidiasis 1, 4
• The Society for Healthcare Epidemiology of America recommends that clindamycin be used with caution in patients at risk of thrush, due to its potential to disrupt normal oral and gastrointestinal flora 1, 2, 4
• The American Dental Association suggests that tetracyclines, such as doxycycline, be used with caution in patients at risk of thrush, as they may contribute to the development of oral candidiasis 1, 2, 4