Fluconazole versus nystatin in the treatment of oral candidosis.
The efficacy of oral fluconazole versus nystatin was evaluated as a treatment modality for oral candidosis. Of the included patients (n = 60), two-thirds presented with an erythematous candidosis, and the others showed clinical signs compatible with a pseudomembranous candidosis. Predisposing factors were xerostomia (n = 18), HIV (n = 5), immunosuppression in conjunction with organ transplantation (n = 10), and wearing of dentures (n = 14). For the remaining patients no specific predisposing factors were found. One patient who was treated with nystatin was excluded owing to nausea that was related to the antifungal treatment. After 7 days of treatment with fluconazole (50 mg/day), the affected oral mucosa, assessed by the investigator, was cured or showed considerable improvement in 87% of the patients (n = 30). The corresponding figure for the nystatin group (n = 30), rinsing with 1 mL 4 times a day for 21 days, was 80%. Following treatment with fluconazole, 20 of 22 patients with symptoms at the start (91%) reported improvement. The comparable figures for the nystatin group were 10 of 12 patients (83%). Half of the patients in the nystatin group reported inconvenience from taking the medication (mean value = 25.9) compared with 23% of the patients in the fluconazole group (mean value = 6.6). Eight patients in the fluconazole group and 12 patients in the nystatin group exhibited a relapse within 6 months. These differences were not found to be statistically significant. The patients in the fluconazole group reported less inconvenience from taking the medication, a finding that may have clinical implications for compliance.
Ostra University Hospital, and Department of Endodontology/Oral Diagnosis, Faculty of Odontology, Göteborg University, Sweden.
J
J
Blomgren
U
U
Berggren
M
M
Jontell
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002180:Candidiasis, Oral / Q000145:classification / Q000188:drug therapy* / Q000473:pathology; D002214:Capsules; D003778:Dentures / Q000009:adverse effects; D004890:Erythema / Q000473:pathology; D005260:Female; D015725:Fluconazole / Q000008:administration & dosage / Q000627:therapeutic use*; D005500:Follow-Up Studies; D015658:HIV Infections / Q000150:complications; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000187:drug effects / Q000473:pathology; D009067:Mouthwashes; D009761:Nystatin / Q000008:administration & dosage / Q000627:therapeutic use*; D016377:Organ Transplantation / Q000009:adverse effects; D010349:Patient Compliance; D017060:Patient Satisfaction; D012008:Recurrence; D012307:Risk Factors; D014987:Xerostomia / Q000150:complications
D000935:Antifungal Agents; D002214:Capsules; D009067:Mouthwashes; D009761:Nystatin; D015725:Fluconazole