title: Effects of lawsone methyl ether mouthwash on oral Candida in HIV-infected subjects and subjects with denture stomatitis.
abstract: OBJECTIVE
  To determine (i) effects of lawsone methyl ether (LME) mouthwash on antifungal drug resistance of oral Candida, (ii) effects of LME mouthwash on changes in genotype of oral Candida, and (iii) allergy and subjects' satisfaction on LME mouthwash in comparison with chlorhexidine (CHX).
  
  
  METHODS
  A randomized clinical trial was conducted in HIV-infected subjects and denture wearers receiving either LME or CHX mouthwash. Candidal culture by oral rinse technique was performed as baseline and after using the mouthwash for 2 weeks. Antifungal drug resistance and changes in genotype of oral Candida were assessed by microdilution assay, inverted repeat polymerase chain reaction and restriction fragment length polymorphism assays, respectively. Allergy and subjects' satisfaction on the mouthwashes were recorded. Statistical analysis was performed using Chi-squared and Fisher's exact tests.
  
  
  RESULTS
  Twenty-nine HIV-infected subjects (age range, 26-54 years; mean age, 41 years) and 38 denture wearers (age range, 27-76 years; mean age, 55 years) were enrolled. C. albicans was the most common specie found in both groups followed by C. tropicalis, C. parapsilosis, and C. glabrata. Neither antifungal drug resistance nor significant changes in genotyping of Candida were noted among those receiving LME mouthwash. Subjects' satisfaction on taste and smell of LME mouthwash was comparable to that of CHX.
  
  
  CONCLUSIONS
  Use of LME mouthwash for 2 weeks neither led to antifungal drug resistance nor significant changes in genotype of oral Candida. Thus, LME may be an alternative mouthwash in prophylaxis of oral candidiasis among those at risk of developing the disease.
authors.affiliation: Prince of Songkla University, Hat Yai, Songkhla, Thailand; Phytomedicine and Pharmaceutical Biotechnology Research Center, Faculty of Pharmaceutical Sciences, Prince of Songkla University, Hat Yai, Songkhla, Thailand; Natural Product Research Center of Excellence, Faculty of Science, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
authors.forename: Wipawee
authors.initials: W
authors.lastname: Nittayananta
authors.forename: Kanokporn
authors.initials: K
authors.lastname: Pangsomboon
authors.forename: Pharkphoom
authors.initials: P
authors.lastname: Panichayupakaranant
authors.forename: Nilnara
authors.initials: N
authors.lastname: Chanowanna
authors.forename: Sureerat
authors.initials: S
authors.lastname: Chelae
authors.forename: Varaporn
authors.initials: V
authors.lastname: Vuddhakul
authors.forename: Pharanai
authors.initials: P
authors.lastname: Sukhumungoon
authors.forename: Nannapat
authors.initials: N
authors.lastname: Pruphetkaew
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000517:prevention & control*; D000328:Adult; D000368:Aged; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use*; D002175:Candida / Q000145:classification / Q000187:drug effects*; D002176:Candida albicans / Q000302:isolation & purification; D041221:Candida glabrata / Q000302:isolation & purification; D041022:Candida tropicalis / Q000302:isolation & purification; D002180:Candidiasis, Oral / Q000517:prevention & control*; D002710:Chlorhexidine / Q000627:therapeutic use; D025141:Drug Resistance, Fungal; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000382:microbiology*; D006801:Humans; D006967:Hypersensitivity / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009067:Mouthwashes / Q000627:therapeutic use*; D009285:Naphthoquinones / Q000627:therapeutic use*; D017060:Patient Satisfaction; D012903:Smell / Q000187:drug effects; D013282:Stomatitis, Denture / Q000517:prevention & control*; D013649:Taste / Q000187:drug effects
chemical_list: D000891:Anti-Infective Agents, Local; D000935:Antifungal Agents; D009067:Mouthwashes; D009285:Naphthoquinones; C096118:2-methoxy-1,4-naphthoquinone; D002710:Chlorhexidine
keywords: Candida; HIV; antifungal activity; antifungal drug resistance; chlorhexidine; genotyping; lawsone methyl ether; mouthwash