Oropharyngeal candidiasis: a review of its clinical spectrum and current therapies.

With the increased use of antibiotics and immunosuppressive agents, oropharyngeal candidiasis is becoming more common. This infection is also associated with such advances in medical management as chemotherapy and organ transplantation and with human immunodeficiency virus infection. Various topical and systemic agents are available to treat patients with candidiasis, but optimal management can be elusive. Treatment of uncomplicated oropharyngeal candidiasis in the immunocompetent patient involves selecting a particular formulation of a topical medication based on oral conditions, length of contact time, and taste, texture, and cost of the medication. Treatment of severe oropharyngeal candidiasis, particularly in patients with a compromised immune system, is often more difficult, and relapses are common. Reports of resistance to systemic agents, particularly in patients needing recurrent therapy, are increasing. Amphotericin B, long used as an intravenous agent, is now available as an oral suspension that may offer therapeutic benefits comparable to those of systemic therapy without the toxicity associated with systemic absorption.