Prescription medicines that inhibit the growth of yeast (antifungals) are used to treat thrush.
Antifungal medicines are either applied directly to the affected area (topical) so the medicine affects only that area, or swallowed (oral) so the medicine affects the entire body. In rare cases, an antifungal medicine will need to be injected into a vein (intravenous, or IV).
Topical antifungal medicines
Topical antifungal medicines are applied to the affected area and are available in several forms, such as rinses and lozenges.
Topical antifungal medicines need to be in contact with the affected area long enough to stop the growth of the yeast. Lozenges are preferred because they take longer to dissolve. Because the lozenges need moisture to dissolve, sipping water while using them may help them work better.
Because several of the topical antifungal medicines contain sugar, there is an increased risk of cavities when the medicines are used for long periods of time. Using a topical fluoride rinse or gel (if you are not already obtaining fluoride through other means) during treatment may help prevent cavities. Talk to your doctor or dentist before you give your child fluoride products. Too much fluoride may be toxic and can stain a child's teeth.
Oral antifungal medicines (pills)
Unlike topical antifungal medicines, oral antifungal medicines affect the whole body. Your doctor may prescribe a pill if you have a thrush infection in your esophagus. Your doctor may suggest that you use a topical antifungal medicine along with it.
Oral antifungal medicines are used to prevent thrush in certain people with conditions that weaken the body's immune system.
- Polyenes (such as nystatin)
- Azoles (such as clotrimazole, fluconazole, and itraconazole)
- Gentian violet (1%), an over-the counter product
What to think about
- The type of medicine prescribed will depend on your or your child's health, how bad the infection is, how long the infection has been present, and/or whether the infection has come back.
- Infants are nearly always treated with topical antifungal medicines. Topical medicines don't work as well in adults, because adults have bigger mouths and it is hard to cover the affected areas.
- Both polyenes and azoles cure thrush most of the time.
- An azole or nystatin is usually the first medicine used to treat thrush in children.1
- If thrush does not respond to medicines, your doctor may do a culture test to find out whether drug-resistant strains of yeast are causing the infection.