Management of DR-TB ADR: Superficial Fungal Infection and Thrush

Superficial fungal infection is a rare and non-serious Adverse Drug Reaction (ADR) to regimens containing fluoroquinolones. It can present as an itchy rash with swelling, discharge and pain. It can also occur in the mouth as oral thrush, which presents with thick white patches on the tongue and cheeks, and sometimes with pain or burning.

It can easily be identified by field-level health care workers and is often reported by patients on their own. It can be managed conservatively at the Peripheral Health Institution (PHI) but if the patient has co-morbidities, then this ADR is best managed at the nearest DR-TB centre.

Suspected agent(s): Fluoroquinolone (FQ)

Suggested Management Strategies

• Topical antifungal agents or short-course oral antifungal drugs are helpful.
• Exclude other diseases if the response to treatment is not prompt (such as HIV).

Points to Note

Vaginal or penile candidiasis, oral thrush or cutaneous candidiasis in skin folds may occur with antibiotic treatment.

Resources

• Guidelines for Programmatic Management of Drug-resistant Tuberculosis in India, March 2021. 
• Ready Reckoner for Medical Officer - Adverse Drug Reactions Associated with Anti-TB Drugs Identification and Management, 2019.​

Kindly provide your valuable feedback on the page to the link provided HERE