Treatment of thrush in oncology patients

The oral cavity is a common site for fungal infections, especially candidiasis, in patients with hematologic neoplasms and those treated with chemotherapy. Clinical experience at Memorial Sloan-Kettering Cancer Center has shown that a program combining good oral care and antifungal therapy is effective in this patient population. Local therapy is recommended for mild to moderate disease. Azoles are used with more serious infection and low-dose amphotericin B is instituted when azole resistance is seen. The use of systemic antifungal agents for the prevention of infection is questionable since the cost of oral azoles may be prohibitive and azole-resistant oral candidiasis has become increasingly common. Oral amphotericin B, however, may offer a new choice for prophylaxis.