Fluconazole versus nystatin in the treatment of oral candidosis

• Published in: Acta odontologica Scandinavica Vol. 56; no. 4; p. 202
• Main Authors: Blomgren, J, Berggren, U, Jontell, M
• Format: Journal Article
• Language: English
• Published: England 1998
• Subjects: Administration, Oral; Adult; Aged; Antifungal Agents - administration & dosage; Antifungal Agents - therapeutic use; Candidiasis, Oral - classification; Candidiasis, Oral - drug therapy; Candidiasis, Oral - pathology; Capsules; Dentures - adverse effects; Erythema - pathology; Female; Fluconazole - administration & dosage; Fluconazole - therapeutic use; Follow-Up Studies; HIV Infections - complications; Humans; Immunosuppression - adverse effects; Male; Middle Aged; Mouth Mucosa - drug effects; Mouth Mucosa - pathology; Mouthwashes; Nystatin - administration & dosage; Nystatin - therapeutic use; Organ Transplantation - adverse effects; Patient Compliance; Patient Satisfaction; Recurrence; Risk Factors; Xerostomia - complications
• DOI: 10.1080/00016359850142790
• ISSN: 0001-6357

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.