Which antifungal agent is listed as systemic therapy for oral candidiasis?

• A. Nystatin oral suspension
• B. Clotrimazole troches
• C. Fluconazole
• D. Miconazole oral gel

Answer: (C)

Systemic therapy for oral candidiasis requires a drug that is absorbed into the bloodstream and reaches the oral tissues from the circulation. Fluconazole fits this because it has high oral bioavailability and distributes well into saliva and oral mucosa, providing effective antifungal activity against Candida species. It’s commonly used when disease is extensive, recalcitrant to topical therapy, or in patients where systemic treatment is preferred. The other options act locally in the mouth with minimal systemic absorption—nystatin suspension, clotrimazole troches, and miconazole gel—so they’re considered topical therapies rather than systemic.