Anyone out there have trouble getting physicians to order fluconazole for
ductal thrush?  I don't get it.  One of our moms came in over the weekend
with unrelenting thrush.  She saw her obstetrician and gave him Dr. Newman's
fluconazole article from the web, but he refused to treat her with it.  She
treated herself with gential violet as directed, and improved somewhat
herself while the baby cleared up right away.  In pain, she went to see the
pediatrician and gave him the web article, which she remarked she had
received from us.  He put her on it, 200mg stat, and 100 mg per day.  When
she improved but it didn't eradicate it, she wanted 200 mg/day and he refused
to increase it.  He then called me and chewed me out and said the article
should not be in the hands of patients, but should go to physicians directly.
 The article is public knowledge on the web.  How can it be wrong for us to
provide it to patients who come to us in pain?  Guess I will have to give
them Jack's web address and have them read it for themselves!  Then they can
say "I read it on the web".  These doctors!  This is not the first time.  I
have one that won't consider Reglan either.  What do we do?  Anyone else have
this problem?  Loni Denman, RN, IBCLC

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