Topical therapies like nystatin or clotrimazole are often used initially.[74], [75] Systemic antifungal therapy is often required; fluconazole is the agent of choice at a dose of 150 mg single dose given immediately. Itraconazole and voriconazole are alternative agents for disease that is not responsive to fluconazole. Secondary prophylaxis with fluconazole is not normally recommended but may be used for recurrent disease.[76]