Antifungal Therapy - 2
Fungal infections are treated either topically or systemically, depending upon the extent and severity of the infection. Azole antifungals are used to treat chronic, extensive mucocutaneous candidiasis, while polyenes are used to treat local candidiasis.53 Some antifungals are being used in combination with corticosteroids, such as nystatin and triamcinolone (Mycolog II®), to treat both the fungal infection and the inflammation of angular cheilitis. In general, medications must be used for a minimum of 48 hours after the disappearance of clinical signs and symptoms, with a re-evaluation of the condition 14 days after therapy has been completed. The efficacy of topical drugs is dependent upon contact with the lesions, thus the benefit of using troches, creams and lotions. Liquid swish and swallow preparations are available, and are also used to treat infections associated with dental appliances and dentures. Caution is advised when using systemic antifungal therapy, as resistance may develop which could render the drug ineffective in cases of life-threatening candidiasis.53Topical and systemic antifungal medications are summarized in Table 4 and Table 5 respectively.
