Clotrimazole
The white patchy lesions represent oral candidiasis (thrush), a common complication of inhaled corticosteroid use. Inhaled steroids can cause local immunosuppression in the oropharynx, predisposing to fungal infections. Clotrimazole is the treatment of choice as: 1) It is available in topical formulations (troches/oral lozenges) for oral candidiasis, 2) It is effective against Candida species, 3) It has minimal systemic absorption when used topically. Prevention: patients should rinse mouth after using inhaled steroids. Other options: Griseofulvin is for dermatophytes, Terbinafine is for dermatophytes and onychomycosis, Flucytosine is reserved for systemic fungal infections.