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Doctors' Answers to "Frequently Asked Questions" - Candiasis

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

Candiasis - Oral Thrush [posted 1/11/99]
Question: I recently developed a case of oral thrush after taking 10 days of 1000 mg. Augmentin. My doctor tried Mycelex troches first, then at my urging prescribed Nystatin suspension. I had requested Nystatin powder because some of the posts in the various forums indicated that the glucose syrup of the suspension would only make the condition worse. It is getting worse and has spread to the back of my throat, and I don't know how far down from there. I have had no appetite these 4 weeks since the problems began, but I have only been on the anti-fungals for a little over 2 weeks. I now have a prescription for Diflucan, 100 mg, but it is terribly expensive and the doctor only prescribed 10 days worth. My drug book recommends a minimum of 3 weeks treatment for esophageal occurrences. There are no refills on the prescription. What would you recommend? Also, I had a similar outbreak 2 years ago after antibiotics, but it responded OK to the Nystatin suspension that the ENT prescribed at that time. What is going on here with my immune system that it can't seem to fight this off? I am HIV negative, but that seems to be the only disease I see commonly mentioned with regards to immune suppression. I do not suffer from an abundance of sickness. In fact it has been many months since I have even had a cold. Do other CFIDS patients exhibit suppressed immune function? I just had a complete battery of blood work with everything except cortisol in line. I am having an MRI of the adrenals this week to rule out a problem there, but my stress level on the day of the test was abnormally high, so I think this test will likely turn out normal also. Any suggestions as to what to do next will be much appreciated.

Answer: One week should be enough. I would start treatment for oral thrush with any antibiotics that you take. Many people think the immune system is involved in chronic fatigue, but documentation has been harder to come by.

Diflucan and Candiasis
Question: Have you found diflucan to be reliable in counteracting candiasis? If so, what are the side effects?

Answer: In general yes, if the individual has an intact immune system. The side effects are potential liver toxicity(usually time and dose related), elevated cholesterol, skin rashes, low white cell counts, and seizures are reported but rare. One or two dose therapy for vaginal candiasis is usually quite safe--occasional patients will develop skin rashes and allergic type reactions.

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