Oral candidiasis (thrush)

November 2005     View PDF     En español

Anti-fungal drugs and pregnancy

The Guidelines for the Prevention of Opportunistic Infections include recommendations regarding the use of anti-fungal drugs during pregnancy. In short, the Guidelines recommend that the oral azole anti-fungals (including fluconazole, itraconazole and ketoconazole) not be started during pregnancy because of concerns to the developing child. The Guidelines further state that these drugs be discontinued in HIV-positive women who become pregnant and that women receiving these drugs take effective birth control.

For the treatment or prevention of oral candidiasis, topical anti-fungal therapies such as nystatin may be preferable for pregnant women. Amphotericin B is also approved for the treatment of oral candidiasis. Although no formal studies have been performed, amphotericin B has been used by pregnant women without apparent harm to their unborn children. While amphotericin B may be preferable to azole therapy in pregnant women, it is not without potentially severe side effects, including kidney toxicity and anemia.