Nipple and breast thrush - Antibiotic Prescribing

Comment from expert advisory group

  • The use of all-purpose nipple ointment is not recommended as treatment option.
  • Second line systemic fluconazole should only be used in exceptional circumstances and under medical supervision for deep candida mastitis which is very rare.
  • There is a significant risk of drug interactions and caution must be exercised when using fluconazole.


nipple breast thrush feb 01 2021 table

Patient Information

Safe Prescribing (visit the safe prescribing page)

  • Doses are oral and for adults unless otherwise stated
  • Renal impairment dosing table
  • Drug interactions table. Extensive drug interactions for clarithromycin, fluoroquinolones, azole antifungals and rifampicin. Many antibiotics increase the risk of bleeding with anticoagulants
  • Visit the Health Products Regulatory Authority (HPRA) website for detailed drug information (summary of product characteristics and patient information leaflets). Dosing details, contraindications and drug interactions can also be found in the Irish Medicines Formulary (IMF) or other reference sources such as British National Formulary (BNF) / BNF for children (BNFC).

Reviewed Jan 2021

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