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]