title: Single-Dose Fluconazole Therapy for Oral Thrush in Hospice and Palliative Medicine Patients.
abstract: BACKGROUND
  Oral thrush is a common fungal infection of the mouth experienced by palliative medicine and hospice patients who have advanced cancer. Individuals often experience distressing symptoms that affect their oral intake with most regimens adding to pill burden. This is an open-label prospective observational study to assess the efficacy of a single-dose fluconazole 150 mg for oral thrush.
  
  
  METHODS
  Palliative medicine and hospice patients with a clinical diagnosis of oral thrush, a life expectancy of more than 1 week, and were able to swallow were enrolled. Signs and symptoms were evaluated on day 1 prior to administration of 150 mg of fluconazole and between days 3 to 5 after treatment.
  
  
  RESULTS
  Of 57 patients, 55 (96.5%) had more than 50% improvement in signs and symptoms. Both the number and severity of symptoms changed significantly posttreatment ( P < .001). Side effects were few.
  
  
  CONCLUSIONS
  Single-dose fluconazole 150 mg is an effective treatment of oral thrush for individuals with advanced cancer.
authors.affiliation: 1 The Harry R. Horvitz Center for Palliative Medicine and Supportive Oncology, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Ruth
authors.initials: R
authors.lastname: Lagman
authors.affiliation: 1 The Harry R. Horvitz Center for Palliative Medicine and Supportive Oncology, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Mellar
authors.initials: M
authors.lastname: Davis
authors.affiliation: 1 The Harry R. Horvitz Center for Palliative Medicine and Supportive Oncology, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: LeGrand
authors.affiliation: 1 The Harry R. Horvitz Center for Palliative Medicine and Supportive Oncology, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Declan
authors.initials: D
authors.lastname: Walsh
authors.affiliation: 1 The Harry R. Horvitz Center for Palliative Medicine and Supportive Oncology, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Armida
authors.initials: A
authors.lastname: Parala
authors.affiliation: 1 The Harry R. Horvitz Center for Palliative Medicine and Supportive Oncology, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Pamela
authors.initials: P
authors.lastname: Gamier
authors.affiliation: 1 The Harry R. Horvitz Center for Palliative Medicine and Supportive Oncology, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Brenda
authors.initials: B
authors.lastname: Cothren
authors.affiliation: 1 The Harry R. Horvitz Center for Palliative Medicine and Supportive Oncology, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Bushra
authors.initials: B
authors.lastname: Cheema
authors.affiliation: 1 The Harry R. Horvitz Center for Palliative Medicine and Supportive Oncology, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Sumi
authors.initials: S
authors.lastname: Gopal
authors.affiliation: 2 Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Rybicki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002180:Candidiasis, Oral / Q000188:drug therapy*; D005260:Female; D015725:Fluconazole / Q000008:administration & dosage / Q000627:therapeutic use*; D017051:Hospice Care / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000628:therapy; D010166:Palliative Care / Q000379:methods*; D011446:Prospective Studies
chemical_list: D000935:Antifungal Agents; D015725:Fluconazole
keywords: advanced cancer; fluconazole; hospice; oral candidiasis; oral thrush; palliative medicine