Miconazole gel and nystatin suspension were compared in a prospective randomised therapeutic trial including 51 cases of oral candidiasis in hospitalised pediatric patients. Clinical evaluations, microscopic examinations and adequate cultures were the basis for diagnosis and follow-up over 3-4 weeks. Miconazole oral gel therapy resulted in an optimal cure rate of 100% and in a relapse rate of only 4%, whereas for nystatin suspension these values were 75% and 22% respectively. However, apart from producing a better effect compared to nystatin suspension, miconazole gel also involved a higher rate of minor gastrointestinal side effects and worse acceptance. Older children often tolerated poorly the sweet taste of miconazole gel. It is recommended that the gel form of the potent antimycotic agent miconazole be mainly used in infants and young children.