In my experience, often mothers and babies have a thrush infection that
clears when just the affected party is treated.
The problems arise when it does not resolve with simple treatment.  In those
cases I have found the issues to be inadequate duration of treatment and/or
reinfection because the partner was not adequately treated as well.

Adequate treatment means continuing with treatment for at least a week after
the last signs and symptoms have disappeared.  Partners include all in
intimate physical contact with the person infected.

Nystatin seems to work well here. However, it only works when in direct
contact with the thrush.  That means ideally, constant application. I
recommend replacement when it has been removed due to drinking, eating, or
wearing off by clothing - at least 3 hourly round the clock as far as
possible.  It is far cheaper than fluconazole (Diflucan), and very safe,
since it is poorly absorbed by the gastrointestinal tract, if at all.  We
are seeing increasing resistance by Candida sp to the azole drugs.

Gentian violet works well, but people don't like everything dyed purple by
it.

Another personal observation is that women who have recurring problems with
thrush (who do not have diabetes or precipitating antibiotic treatment) seem
to have particularly hygienic habits - they are the ones who tend to
bathe/shower twice daily etc.  Being extra clean may remove other
non-pathogenic organisms which normally live on the surfaces of healthy skin
and mucosae. This allows space for organisms like Candida, frequently
present to an innocuous degree, to become a pathogen by overgrowth.
Nan Jolly M.B. B.Ch. LLLL
Port Elizabeth, South Africa

> Also, I have lectured on yeast for many years. Nystatin given four times a
> day doesn't do a lot for an organism that replicates every 30 minutes.
> Kathleen Bruce RN IBCLC

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