nystatin-a1 and Candidiasis--Oral

To evaluate the clinical efficacy of photodynamic therapy (PDT) as an adjunct or alternative to traditional antifungal drugs in the treatment of oral candidiasis, and to provide evidence-based medical evidence for its use in the treatment of oral candidiasis.. Computer combined with manual retrieval of China Academic Journals Full-text Database (CNKI), China Biomedical Literature Database (CBM), Chinese Science and Technology Journal Database (VIP), Wanfang Database, PubMed, Web of Science, Cochrane Library, Embase, Scopus retrieval for articles published before January 2023, basic information and required data were extracted according to the inclusion and exclusion criteria, and the Revman V5.4 software was used to conduct Meta-analysis of the included literature.. A total of 11 articles were included, 7 of which used nystatin as an antifungal drug, 2 of which were combined treatment of PDT and nystatin, 2 of the remaining 4 articles were treated with fluconazole, and 2 were treated with miconazole. Meta results showed that PDT was superior to nystatin in reducing the number of oral candida colonies in the palate of patients MD = -0.87, 95%CI = (-1.52,-0.23), P = 0.008, the difference was statistically significant, and the denture site MD = -1.03, 95%CI = (-2.21, -0.15), P = 0.09, the difference was not statistically significant; compared with the efficacy of fluconazole, RR = 1.01, 95%CI = (0.56,1.83), P = 0.96; compared with miconazole RR = 0.55, 95%CI = (0.38, 0.81), P = 0.002; PDT combined with nystatin RR = 1.27, 95%CI = (1.06, 1.52), P = 0.01; recurrence rate RR = 0.28, 95%CI = (0.09, 0.88), P = 0.03.. PDT was effective in the treatment of oral candidiasis; PDT was more effective than nystatin for the treatment of denture stomatitis in the palate, while there was no significant difference between the two for the denture site; The efficacy of PDT for oral candidiasis was similar to that of fluconazole; PDT was less effective than miconazole for oral candidiasis; Compared with nystatin alone, the combination of PDT and nystatin is more effective in treating oral candidiasis with less risk of recurrence.

Topics: Antifungal Agents; Candidiasis, Oral; Fluconazole; Humans; Miconazole; Nystatin; Photochemotherapy

Candidiasis is one of the most common opportunistic oral infections that presents different acute and chronic clinical presentations with diverse diagnostic and therapeutic approaches. The present study carries out a bibliographic review on the therapeutic tools available against oral candidiasis and their usefulness in each clinical situation.. Recent studies on treatment of oral candidiasis were retrieved from PubMed and Cochrane Library.. Nystatin and miconazole are the most commonly used topical antifungal drugs. Both antifungal drugs are very effective but need a long time of use to eradicate the infection. The pharmacological presentations of miconazole are more comfortable for patients but this drug may interact with other drugs and this fact should be assessed before use. Other topical alternatives for oral candidiasis, such as amphotericin B or clotrimazole, are not available in many countries. Oral fluconazole is effective in treating oral candidiasis that does not respond to topical treatment. Other systemic treatment alternatives, oral or intravenous, less used are itraconazole, voriconazole or posaconazole. Available novelties include echinocandins (anidulafungin, caspofungin) and isavuconazole. Echinocandins can only be used intravenously. Isavuconazole is available for oral and intravenous use. Other hopeful alternatives are new drugs, such as ibrexafungerp, or the use of antibodies, cytokines and antimicrobial peptides.. Nystatin, miconazole, and fluconazole are very effective for treating oral candidiasis. There are systemic alternatives for treating recalcitrant infections, such as the new triazoles, echinocandins, or lipidic presentations of amphotericin B.

Topics: Administration, Intravenous; Administration, Oral; Administration, Topical; Amphotericin B; Anidulafungin; Antifungal Agents; Azoles; Candidiasis, Oral; Caspofungin; Clotrimazole; Databases, Factual; Drug Interactions; Echinocandins; Fluconazole; Humans; Miconazole; Nitriles; Nystatin; Pyridines; Triazoles

The aim of this work was to review the scientific literature on the properties, indications and pitfalls related to nystatin and chlorhexidine in oral medicine and also to compare these to other topical antifungal agents, considering the elderly population.. Nystatin is a polyene antifungal widely used as a topical formulation to treat candidiasis, whereas chlorhexidine is a wide-spectrum antimicrobial, especially used against bacteria, but also effective in treating some fungal infections including those caused by Candida spp. These compounds have been prescribed for immunocompromised patients, hospitalized or not, some of them undergoing head and neck radiation therapy and/or chemotherapy, including elderly patients.. Dental and medical literature concerning the use of nystatin and chlorhexidine in oral medicine were selected and reviewed.. Nystatin and chlorhexidine are gold-standard antimicrobial mouthrinses respectively for Candida spp. and bacteria. Although recognized as effective in cotrolling oral infections, both nystatin and chlorhexidine are just complementary to systemic therapy in cases of systemic infections already established. The prescriber should also take into account that some commercial nystatin and chlorhexidine formulations contain compounds such as sugar and ethanol, which can be associated with side effects. Meanwhile, alternative formulations in which these compounds are absent are available and should be considered.. Further studies investigating new drugs and interactions of drug combinations are necessary to improve the therapeutic management of oral infections.

Topics: Aged; Anti-Infective Agents; Antifungal Agents; Candidiasis, Oral; Chlorhexidine; Humans; Immunocompromised Host; Nystatin; Periodontal Diseases

To systematically review and assess the efficacy, different treatment protocols (formulation, dosage, and duration), and safety of nystatin for treating oral candidiasis.. Four electronic databases were searched for trials published in English till July 1, 2015. Randomized controlled trials comparing nystatin with other antifungal therapies or a placebo were included. Clinical and/or mycological cure was the outcome evaluation. A meta-analysis or descriptive study on the efficacy, treatment protocols, and safety of nystatin was conducted.. The meta-analysis showed that nystatin pastille was significantly superior to placebo in treating denture stomatitis. Nystatin suspension was not superior to fluconazole in treating oral candidiasis in infants, children, or HIV/AIDS patients. The descriptive investigations showed that administration of nystatin suspension and pastilles in combination for 2 weeks might achieve a higher clinical and mycological cure rate, and using the nystatin pastilles alone might have a higher mycological cure rate, when compared with using nystatin suspensions alone. Nystatin pastilles at a dose of 400,000 IU resulted in a significantly higher mycological cure rate than that administrated at a dose of 200,000 IU. Furthermore, treatment with nystatin pastilles for 4 weeks seemed to have better clinical efficacy than treatment for 2 weeks. Descriptive safety assessment showed that poor taste and gastrointestinal adverse reaction are the most common adverse effects of nystatin.. Nystatin pastille was significantly superior to placebo in treating denture stomatitis, while nystatin suspension was not superior to fluconazole in treating oral candidiasis in infants, children, or HIV/AIDS patients. Indirect evidence from a descriptive study demonstrated that administration of nystatin pastille alone or pastille and suspension in combination is more effective than that of suspension alone; prolonged treatment duration for up to 4 weeks can increase the efficacy of nystatin. More well designed and high quality randomized control studies are needed to confirm these findings.

Topics: Candidiasis, Oral; Dose-Response Relationship, Drug; Humans; Nystatin

Dysphagia following cardiac surgery is a frequently encountered problem, being most commonly due to the sternotomy incision and/or prolonged intubation. Oesophageal candidiasis is an increasing problem that is usually associated with immunosuppression or immunodeficiency. We report a 59 years age, immunocompetent lady whom had developed dysphagia and odynophagia following open cardiac surgery and long term course of antibiotics. Diagnosis of Candida oesophagitis was established after radiological, endoscopic and microbiological evidence, and successful treatment with combined topical and systemic antifungal therapy was achieved. Possibility of immunodeficiency was excluded. We believe that this lady developed oesophageal candidiasis due to a long-term course of broad spectrum antibiotics. We discuss the various diagnostic modalities and treatment options.

Topics: Amphotericin B; Anti-Bacterial Agents; Antifungal Agents; Candidiasis, Oral; Deglutition Disorders; Dilatation; Drug Therapy, Combination; Esophagitis; Female; Humans; Immunocompetence; Middle Aged; Nystatin; Thoracic Surgery; Treatment Outcome

Topics: Administration, Oral; Anti-Infective Agents, Local; Antifungal Agents; Candidiasis, Oral; Evidence-Based Medicine; Family Practice; Fluconazole; Gentian Violet; Humans; Infant; Infant Care; Infant, Newborn; Nystatin; Practice Guidelines as Topic

A systematic review of randomized clinical trials published between 1966 and April 2000 was undertaken to determine the strength of evidence for the effectiveness of antifungal drugs (nystatin, clotrimazole, amphotericin B, fluconazole, ketoconazole, and itraconazole) to prevent and treat oral candidiasis in human immunodeficiency virus-positive patients.. An automated database search identified 366 articles. Six met inclusion and exclusion criteria with respect to prophylaxis; 12 met criteria for treatment of oral candidiasis.. The evidence for the prophylactic efficacy of fluconazole is good, although insufficient to draw conclusions about the other antifungals. Evidence for treatment effectiveness is insufficient for amphotericin B but good for nystatin, clotrimazole, fluconazole, ketoconazole, and itraconazole.. Suggestions for strengthening the evidence base include the following: use of larger, more well-defined groups; control for immunologic status, viral load, history of oral candidiasis, past exposure to antifungals, baseline oral Candida carriage, drug interactions, and antiretroviral therapy; and consistent use of compliance monitors, fungal speciation, and susceptibility testing.

Topics: AIDS-Related Opportunistic Infections; Amphotericin B; Antifungal Agents; Candidiasis; Candidiasis, Oral; Clotrimazole; Databases as Topic; Fluconazole; HIV Seropositivity; Humans; Itraconazole; Ketoconazole; Nystatin; Oropharynx; Pharyngeal Diseases; Randomized Controlled Trials as Topic; Research Design; Statistics as Topic; Treatment Outcome

The salivary component of Sjögren's syndrome (SS) is defined as xerostomia (dry mouth). However, xerostomia is a common symptom associated with quantitative and qualitative changes in saliva, which are generally referred to as salivary hypofunction. This can be caused by various systemic diseases (including SS), anticholinergic effects of many drugs, psychological conditions, and physiological changes. Chronic salivary hypofunction is clinically significant because it can cause oral dysfunction, dental destruction, and mucosal infection. Evaluating patients complaining of xerostomia requires particular attention to their current medications and physical examination of the major salivary glands, teeth, and oral mucosa. Based on that information and the differential diagnosis of salivary hypofunction, appropriate tests can then be selected to develop a final diagnosis. Effective treatment of patients with chronic salivary hypofunction requires a combination of: (1) ongoing dental decay prevention and treatment supervised by their dentist; (2) salivary flow stimulation; (3) recognition and treatment of chronic oral candidiasis; (4) selective use of saliva substitutes; and (5) prescription drug review.

Topics: Antifungal Agents; Candidiasis, Oral; Diagnosis, Differential; Humans; Nystatin; Sjogren's Syndrome; Xerostomia

As both humans and fungi are eukaryotic organisms, antifungal agents affect their cellular metabolism. Thus, a relatively few antifungals with minimal toxicity and side-effects are available compared with a plethora of antibacterials. These agents currently prescribed in dentistry belong to two major groups, the polyenes (nystatin and amphotericin B) and the azoles (imidazoles and triazoles). A newly recognized phenomenon known as the post-antifungal effect implies that antifungals, even at sub-therapeutic concentrations, may suppress the virulent attributes of yeasts, especially intra-orally where topical drug levels fluctuate dramatically during dosing intervals.

Topics: Amphotericin B; Antifungal Agents; Candida; Candidiasis, Oral; Clotrimazole; Drug Interactions; Drug Resistance, Microbial; Fluconazole; Humans; Itraconazole; Ketoconazole; Miconazole; Nystatin; Virulence

The advent of the human immunodeficiency virus infection and the increasing prevalence of compromised individuals in the community due to modern therapeutic advances have resulted in a resurgence of opportunistic infections, including oral candidoses. One form of the latter presents classically as a white lesion of "thrush" and is usually easily diagnosed and cured. Nonetheless, a minority of these lesions appears in new guises such as erythematous candidosis, thereby confounding the unwary clinician and complicating its management. Despite the availability of several effective antimycotics for the treatment of oral candidoses, failure of therapy is not uncommon due to the unique environment of the oral cavity, where the flushing effect of saliva and the cleansing action of the oral musculature tend to reduce the drug concentration to sub-therapeutic levels. This problem has been partly circumvented by the introduction of the triazole agents, which initially appeared to be highly effective. However, an alarming increase of organisms resistant to the triazoles has been reported recently. In this review, an overview of clinical manifestations of oral candidoses and recent advances in antimycotic therapy is given, together with newer concepts, such as the post-antifungal effect (PAFE) and its possible therapeutic implications.

Topics: AIDS-Related Opportunistic Infections; Amphotericin B; Anti-Infective Agents, Local; Antifungal Agents; Candida; Candidiasis, Oral; Chlorhexidine; Clotrimazole; Drug Resistance, Fungal; Fluconazole; Flucytosine; Humans; Immunocompromised Host; Itraconazole; Ketoconazole; Miconazole; Mouth; Nystatin; Opportunistic Infections; Saliva; Treatment Failure; Triazoles

The incidence of oropharyngeal candidiasis is growing. The species of the genus Candida are extremely frequent among human colonizers. The changes in the yeast-human interaction by aging, debilitating, and immunosuppressive diseases, and the more aggressive medical interventions can explain this phenomenon. Antifungals are used both in prophylaxis and therapy, but the number of available agents remains scarce. Acquired resistance to the more commonly used antifungal agents, the azole compounds, is also an increasing threat, Policies for antifungal use should be established in order to maintain the therapeutic possibilities of the current compounds, The widespread use of systemic azoles, agents useful in deep mycosis, may increasingly exert a selective power for resistant variants. Superficial infections, such as oropharyngeal candidiasis, can be successfully controlled by nystatin, a classic polyene, which is very well tolerated and has very low rates of resistance. This review on the importance of oropharyngeal candidiasis emphasizes this therapeutic possibility, and is complemented by in vitro studies documenting the excellent activity of nystatin on both azole-susceptible and resistant strains.

Topics: Animals; Antifungal Agents; Candidiasis, Oral; Humans; Nystatin; Pharyngeal Diseases

The oral cavity and the oesophagus are the main sites of involvement in orointestinal candidosis. The clinical pictures of these manifestations are characterized. Involvement of the stomach as well as the small and large intestine is an exceedingly rare but possible manifestation. There are obviously no repeatedly occurring characteristical symptoms, neither have controlled studies confirmed such characteristics. Recently a discussion has arised-undoubtedly to a large extent influenced by public media-to explain a variety of in particular gastrointestinal symptoms as a consequence of an apparent "mycotic infection of the orointestinal tract" as "a new mass disease". These reports lack any scientific basis supported by experimental or clinical studies. There are similarities to the "candidiasis hypersensitivity syndrome" or "the yeast connection", the existence of which has been critically denied by experts. Corresponding references are given. The author realizes the necessity to oppose this public debate on a critical scientific basis and to answer open questions by controlled studies.

Topics: Antifungal Agents; Candidiasis; Candidiasis, Oral; Esophagitis; Humans; Intestinal Diseases; Nystatin; Stomach Diseases; Syndrome

Most HIV-positive patients develop some form of oral candidiasis, most commonly pseudomembranous candidiasis, erythematous candidiasis, or angular cheilitis, at some point in their disease. All these manifestations are important risk markers for disease progression. Oral candidiasis is generally caused by Candida albicans. Although oral candidiasis can occur at any stage of HIV infection, it is most common in patients with low CD4 counts. Numerous oral and systemic therapies are used to treat oral candidiasis, the most popular of which are nystatin (topical), clotrimazole (topical), ketoconazole (systemic), fluconazole (systemic), and itraconazole (systemic). The topical agents are available in assorted dosage forms with varying degrees of efficacy and patient acceptability. The limited data currently available suggest an advantage for the systemic agents, although problems with resistance may limit the usefulness of fluconazole. The efficacy, safety, and cost effectiveness of a given agent must be considered when prescribing a specific agent for the treatment of oral candidiasis.

Topics: Administration, Oral; Administration, Topical; Antifungal Agents; Candidiasis, Oral; CD4-Positive T-Lymphocytes; Clotrimazole; Fluconazole; HIV Infections; Humans; Ketoconazole; Leukocyte Count; Nystatin; Risk Factors

Topics: Amphotericin B; Candidiasis, Oral; Denture, Complete; Denture, Partial; Disease Susceptibility; Humans; Miconazole; Nystatin; Stomatitis, Denture

Topics: Acetylglucosamine; Adult; Aged; Amphotericin B; Candida albicans; Candidiasis, Oral; Humans; Nystatin

Topics: Amphotericin B; Candida; Candidiasis; Candidiasis, Cutaneous; Candidiasis, Oral; Candidiasis, Vulvovaginal; Cheilitis; Female; Folliculitis; Gastrointestinal Diseases; Humans; Immunologic Deficiency Syndromes; Intertrigo; Leukoplakia, Oral; Male; Nystatin; Paronychia

Topics: Aged; Anti-Infective Agents; Anti-Infective Agents, Local; Candidiasis, Oral; Diagnosis, Differential; Female; Humans; Leukoplakia, Oral; Lichen Planus; Male; Middle Aged; Mouth Diseases; Nystatin

Topics: Candida; Candidiasis; Candidiasis, Cutaneous; Candidiasis, Oral; Candidiasis, Vulvovaginal; Female; Humans; Male; Nystatin; Ointments; Powders; Suppositories; Suspensions; Tablets

It was analyzed the efficacy of mouthwash and spray containing essential oil (EO) of Cinnamomum zeylanicum Blume for the treatment of oral candidiasis.. A randomized, controlled, and blinded clinical trial was conducted with 36 individuals (probabilistic sample) with oral candidiasis who were divided into two treatment groups: C. zeylanicum (0.5 mg/mL), n = 18; nystatin (100,000IU/mL), n = 18. The efficacy of the products was evaluated by two parameters: (a) clinical evolution recorded by calibrated examiners (Kappa = 0.822) according to Newton's classification and (b) reduction of colony-forming units/mL. Mycological and clinical parameters were analyzed before and at 15 days after treatment. Clinical examination of the mucosa showed that C. zeylanicum (p < 0.0339) and nystatin (p < .0139) had efficacy, resulting in a reduction of signs and symptoms (Mann-Whitney test). Mycological analysis showed that C. zeylanicum caused a reduction of 61% and 33% of Candida spp., isolates oral mucosa and dentures, respectively. Candida tropicalis strains were eliminated after C. zeylanicum, in both sites. The participants reported a pleasant taste and few product-related complaints.. C. zeylanicum EO and nystatin exhibited clinical efficacy, according to the Newton classification, and reducing in Candida spp. The clinical trial has been registered (Registration number: NBR-33s6 × 5, ensaiosclinicos.gov.br).

Topics: Antifungal Agents; Candidiasis, Oral; Cinnamomum zeylanicum; Humans; Nystatin; Oils, Volatile

To evaluate the efficacy and safety of Streptococcus salivarius K12 as an adjuvant in treating oral candidiasis.. A total of 56 patients were participated in the randomized, double-blinded, placebo-controlled clinical trial. The S. salivarius K12 or placebo lozenges plus nystatin tablets were given for up to 4 weeks at 1-week interval and then followed up for 1 week thereafter. We collected and analyzed the mycological and clinical data, treatment course, and safety data.. At the end of the treatment, significant differences were found in the mycological cure rates between K12 group and control group (90.48% and 55.56%, respectively, p = 0.008). Survival analysis demonstrated no statistical difference in overall cure rates comprehensively considering mycological cure, clinical improvement, and recurrence (p = 0.078), while statistical difference was found in mycological cure (p = 0.013) between the two groups. The median treatment courses of K12 group and control group were 3 weeks and 4 weeks, respectively. No severe events were reported during the study.. Streptococcus salivarius K12 exhibited potential efficacy and safety as an adjuvant in treating oral candidiasis by enhancing mycological cure and shortening the treatment course of conventional antifungal therapy in this randomized, double-blinded, placebo-controlled clinical trial. Further large-scale clinical studies are desired to accumulate more evidence for its clinical applications.

Topics: Administration, Oral; Anti-Bacterial Agents; Candida albicans; Candidiasis, Oral; Double-Blind Method; Humans; Nystatin; Probiotics; Recurrence; Streptococcus salivarius

Candida species have an influence in the pathogenesis of denture stomatitis. The current study aimed to investigate the efficacy of indocyanine green (ICG)-mediated photodynamic therapy (PDT) in combination with nystatin mouthwash (PDT + nystatin) for the treatment of denture stomatitis in comparison with routine antifungal therapy with nystatin alone.. In this double-blind randomized clinical trial, 66 patients were randomly assigned into PDT + nystatin (n = 33) and nystatin (n = 33) groups, both groups were treated 3-times a day (15 days) with nystatin mouthwash, and PDT was performed twice once a week for the PDT + nystatin group. Briefly, ICG was applied on the palatal lesion and laser irradiation was performed using a diode laser (810 nm, 56 J/cm. Patient treatment with nystatin or PDT + nystatin reduced the lesions extension. Candida species were isolated from all patients and the number of Candida CFU in both groups showed a significant reduction at each post-treatment visit; however, the mean reduction achieved in the PDT + nystatin group was significantly higher than nystatin alone.. ICG-mediated PDT in combination with nystatin mouthwash can improve the clinical feature of denture stomatitis with no adverse effects; therefore, it could be used as an alternative to the currently available antifungal therapy using nystatin alone.

Topics: Aged; Antifungal Agents; Candidiasis, Oral; Double-Blind Method; Drug Therapy, Combination; Female; Humans; Indocyanine Green; Lasers, Semiconductor; Male; Middle Aged; Nystatin; Photochemotherapy; Photosensitizing Agents; Stomatitis, Denture

Compare the safety and efficacy of topical gentian violet with that of nystatin oral suspension (NYS) for the treatment of oropharyngeal candidiasis in HIV-1-infected adults in resource-limited settings.. Multicenter, open-label, evaluator-blinded, randomized clinical trial at eight international sites, within the AIDS Clinical Trials Group.. Adult HIV-infected participants with oropharyngeal candidiasis, stratified by CD4 cell counts and antiretroviral therapy status at study entry, were randomized to receive either gentian violet (0.00165%, BID) or NYS (500 000 units, QID) for 14 days.. Cure or improvement after 14 days of treatment. Signs and symptoms of oropharyngeal candidiasis were evaluated in an evaluator-blinded manner.. The study was closed early per Data Safety Monitoring Board after enrolling 221 participants (target = 494). Among the 182 participants eligible for efficacy analysis, 63 (68.5%) in the gentian violet arm had cure or improvement of oropharyngeal candidiasis versus 61 (67.8%) in the NYS arm, resulting in a nonsizable difference of 0.007 (95% confidence interval: -0.129, 0.143). There was no sizable difference in cure rates between the two arms (-0.0007; 95% confidence interval: -0.146, 0.131). No gentian violet-related adverse events were noted. No sizable differences were identified in tolerance, adherence, quality of life, or acceptability of study drugs. In gentian violet arm, 61 and 39% of participants reported 'no' and 'mild-to-moderate' staining, respectively. Cost for medication procurement was significantly lower for gentian violet versus NYS (median $2.51 and 19.42, respectively, P = 0.01).. Efficacy of gentian violet was not statistically different than NYS, was well tolerated, and its procurement cost was substantially less than NYS.

Topics: Administration, Oral; Administration, Topical; Adolescent; Adult; Aged; Aged, 80 and over; Antifungal Agents; Candidiasis, Oral; Drug-Related Side Effects and Adverse Reactions; Female; Gentian Violet; Health Care Costs; HIV Infections; Humans; Male; Middle Aged; Nystatin; Single-Blind Method; Treatment Outcome; Young Adult

Extended use of antimycotics in oral candidiasis therapy gives rise to problems related to fungal drug resistance. The aim of this pilot study was to investigate the efficacy of tissue tolerable plasma (TTP) in denture stomatitis patients. It was hypothesised that (I): erythema and (IIa): complaint remission would be accelerated and (IIb): colony forming unit (CFU) reduction would be improved. The halves of the upper jaws of eight patients were randomly assigned to control (nystatin, chlorhexidine and placebo treatment) and test sides (nystatin, chlorhexidine and TTP administered six times each 7 days). The patients and the investigators, who were different from the therapists, were both blinded. Compared to the control sides, the erythema surface was reduced significantly more extensively on the test sides between 2 and 6 weeks of antifungal therapy (P ≤ 0.05). Visual analogue scale values and the frequency of moderate or heavy growth of Candida post-treatment did not differ significantly between both sides (P > 0.05). The primary hypothesis was confirmed, which may be interpreted as an accelerated remission. As drug therapy is usually limited to the time in which signs of infection are present, TTP might help reducing antifungal use. Even though the secondary hypotheses were not confirmed, persistence of Candida might be only colonisation.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Antifungal Agents; Candida; Candidiasis, Oral; Chlorhexidine; Dentures; Double-Blind Method; Drug Resistance, Fungal; Erythema; Female; Humans; Male; Middle Aged; Mouth Mucosa; Mouthwashes; Nystatin; Pilot Projects; Plasma Gases; Young Adult

This study aimed at evaluating the short-term efficacy and safety of probiotics as an aid in the treatment of Candida-associated stomatitis in a randomised controlled trial. A total of 65 patients were randomly assigned to receive oral local antifungal agents alone (gargle 2% sodium bicarbonate solution for 30 s, wait 10 min and then apply 2% nystatin paste) or these agents plus local probiotics (the mixture of Bifidobacterium longum, Lactobacillus bulgaricus and Streptococcus thermophilus) three times per day for 4 weeks. Parameters related to hyperaemia, visual analogue scale scores, culture of resting saliva and a lingual dorsum swab and adverse reactions were assessed or recorded in the beginning, middle and end of treatment. Although the baseline characteristics of the participants were similar, both groups showed a significant reduction in pain level and hyperaemia on the tongue mucosa (P = 0.000) after 4-week application. However, despite the reduction in hyperaemia in the probiotic group, these improvements did not display statistically significant differences. The detection rate of Candida spp. was 100% before treatment and 8.21% in the experimental group and 34.6% in the control group after treatment. The detection rate of Candida spp. decreased (P = 0.000) in both groups and was significantly lower in the probiotic group than the control group (P = 0.038). Other analysed micro-organisms, including the decreased detection rate for Lactobacillus spp. (P = 0.049) and the increased detection rate for Staphylococcus epidermidis (P = 0.019), did not display consistent change trends in the probiotics group. Compared with conventional antifungal therapies for oral candidiasis, the inclusion of locally administered probiotics helped improve certain clinical conditions and reduced the prevalence of Candida spp., although the impact of probiotics on oral bacterial species remains to be further studied.

Topics: Aged; Antifungal Agents; Bifidobacterium; Candida; Candidiasis, Oral; Female; Humans; Lactobacillus; Male; Middle Aged; Nystatin; Probiotics; Sodium Bicarbonate; Streptococcus thermophilus

This study compared the effectiveness of Ricinus communis (RC) with Nystatin (NYS) and Miconazole (MIC) in the treatment of institutionalised elderly with denture stomatitis (DS). They (n = 30) were randomly distributed into three groups: MIC, NYS or RC. Clinical and mycological evaluations were performed prior to the use of the antifungal (baseline) and repeated after 15 and 30 days of treatment. The sample was clinically examined for oral mucosal conditions. Standard photographs were taken of the palate, and the oral candidiasis was classified (Newton's criteria). Mycological investigation was performed by swabbing the palatal mucosa, and Candida spp. were quantified by counting the number of colony-forming units (cfu mL⁻¹). The clinical and mycological data were analysed, respectively by Wilcoxon and Student's t-test (α = 0.05). Significant improvement in the clinical appearance of DS in the MIC and RC groups was observed between the 1st and 3rd collections (MIC - P = 0.018; RC - P = 0.011) as well as between the 2nd and 3rd collections (MIC - P = 0.018; RC - P = 0.011). Neither groups showed a statistically significant reduction in cfu mL⁻¹ at any time. Although none of the treatments decreased the cfu mL⁻¹, it was concluded that Ricinus communis can improve the clinical condition of denture stomatitis in institutionalised elderly patients, showing similar results to Miconazole.

Topics: Administration, Topical; Aged; Aged, 80 and over; Antifungal Agents; Candida; Candidiasis, Oral; Colony Count, Microbial; Denture, Complete; Denture, Partial, Removable; Female; Follow-Up Studies; Humans; Institutionalization; Male; Miconazole; Middle Aged; Mouthwashes; Nystatin; Oral Hygiene; Phytotherapy; Plant Preparations; Ricinus; Stomatitis, Denture; Treatment Outcome

Denture stomatitis (DS) is the most common form of chronic oral candidiasis. The standard treatment for DS is nystatin, which is accompanied with complications such as a bitter taste. The aim of this study was to compare the effect of garlic with nystatin in DS.. This randomised clinical trial study was performed on 40 patients with DS. After obtaining written consent, patients were divided into two groups while members of each group were given either nystatin or garlic extract for 4 weeks. The length and width of erythema area was measured at the end of the first, second, third, and the fourth weeks using a calliper. Data were analysed by SPSS and statistical tests including variance analysis with anova repeated measures, chi-square, and least square differences.. The changes in the length and width of erythema at different times according to the type of treatment were found to be significant while an accelerated recovery was demonstrated for nystatin (p < 0.001). Both regimens resulted in significant recovery (p < 0.0001). Greater satisfaction with the use of garlic rather than nystatin was mentioned (p < 0.0001).. Considering the efficacy of garlic and lack of side effects for this compound and also regarding the nystatin-associated complications, garlic extract can be introduced as a substitution for standard treatment in DS.

Topics: Aged; Antifungal Agents; Candidiasis, Oral; Diarrhea; Double-Blind Method; Erythema; Female; Garlic; Humans; Male; Mouthwashes; Nausea; Nystatin; Patient Satisfaction; Phytotherapy; Plant Extracts; Stomatitis, Denture; Taste Disorders

In this randomized clinical trial, the clinical and mycological efficacy of Photodynamic Therapy (PDT) was compared with that of topical antifungal therapy for the treatment of denture stomatitis (DS) and the prevalence of Candida species was identified. Patients were randomly assigned to one of two groups (n = 20 each); in the nystatin (NYT) group patients received topical treatment with nystatin (100,000 IU) four times daily for 15 days and in the PDT group the denture and palate of patients were sprayed with 500 mg/L of Photogem(®), and after 30 min of incubation, were illuminated by light emitting-diode light at 455 nm (37.5 and 122 J/cm(2), respectively) three times a week for 15 days. Mycological cultures taken from dentures and palates and standard photographs of the palates were taken at baseline (day 0), at the end of the treatment (day 15) and at the follow-up time intervals (days 30, 60 and 90). Colonies were quantified (CFU/mL) and identified by biochemical tests. Data were analysed by Fisher's exact test, analysis of variance and Tukey tests and κ test (α = 0.05). Both treatments significantly reduced the CFU/mL at the end of the treatments and on day 30 of the follow-up period (p <0.05). The NYT and PDT groups showed clinical success rates of 53% and 45%, respectively. Candida albicans was the most prevalent species identified. PDT was as effective as topical nystatin in the treatment of DS.

Topics: Adult; Aged; Aged, 80 and over; Antifungal Agents; Candida; Candidiasis, Oral; Colony Count, Microbial; Female; Humans; Male; Middle Aged; Nystatin; Photochemotherapy; Photosensitizing Agents; Risk Factors; Stomatitis, Denture; Treatment Outcome

In this study, oral sustained release mucoadhesive nystatin tablets were developed to increase nystatin contact time with the oral cavity and mask its unpleasant taste.. The best formulation studied included sustained release agents and it was submitted to physical-mechanical characterization, taste assessment and clinical test in twelve patients. The ultraviolet-visible nystatin methodology was also developed and validated in parallel as an alternative to the pharmacopoeial microbiological dosage method.. The best formulation developed in this study included sustained release agents. The efficacy of this formulation was verified through a clinical assessment, showing that this formulation is more effective (100%) than the commercial oral nystatin suspension used traditionally (50%). Moreover, the UV absorption spectrophotometry method developed to validate the methodology for nystatin content analysis for new oral tablets was shown to be specific, linear, exact and reproducible, as recommended by the ICH regulations.. The oral nystatin tablets developed showed to present faster therapeutic response than the oral aqueous solution through the preliminary clinical assays. The UV absorption spectrophotometry method showed to be an attractive test for the usual routine in the pharmaceutical industry.

Topics: Administration, Oral; Candidiasis, Oral; Chemistry, Pharmaceutical; Delayed-Action Preparations; Humans; Mouth Mucosa; Nystatin; Pilot Projects; Spectrophotometry, Ultraviolet; Tablets; Treatment Outcome

Management of oral candidiasis depends on an accurate diagnosis, identification and elimination of predisposing factors, and, often, use of antifungal agents. Chronic hyperplastic candidosis (CHC) is considered a premalignant lesion of the oral mucosa, occurring as speckled or homogeneous white lesions. If the lesions are untreated, a minor proportion may become dysplastic and progress to carcinoma. The traditional treatment of this lesion is based on the use of antifungal agents. The aim of this study was to examine the efficacy of 0.18% isotretinoin for treatment of nystatin-resistant candidiasis. Isotretinoin was administered topically twice a day for one month to six patients affected by nystatin-resistant CHC. In all six patients, daily antimycotic topical therapy with nystatin for 30 days had failed to resolve the candidal stomatitis. After one month of isotretinoin treatment, five of the six patients were negative for Candida, whereas in untreated control patients the situation was unchanged. Only one patient with suspected sicca syndrome was found to have oral Candida 15 days after the last administration of isotretinoin. None of the patients had any complaints about the medication. These findings suggest that 0.18% isotretinoin applied twice a day for one month is able to suppress nystatin-resistant candidiasis.

Topics: Administration, Topical; Antifungal Agents; Candidiasis, Oral; Chronic Disease; Drug Resistance, Fungal; Female; Humans; Isotretinoin; Male; Middle Aged; Nystatin; Pilot Projects

Oral candidiasis is one of the common diseases seen in HIV/AIDS patients. It is rare if CD4+ cell counts are above 500 microl. Outbreaks are more common as the count drops to 100 microl. It may be more difficult to treat when CD4+ cell counts fall below 50 microl.. A retrospective review of 112 HIV/AIDS patients with lesions in the mouth, head, and neck seen at the oral and maxillofacial surgery units of two public hospitals in eastern Nigeria was carried out between 2000 and 2003. The focus was on oral candidiasis patients. Twenty-nine of these patients, made up of 11 males and 18 females, had oral candidiasis. To compare the action of two drugs, namely, nystatin (a topical antifungal drug) and ketoconazole (a systemic antifungal drug), we treated 15 of the patients with nystatin in the first 2 years and the remaining 14 with ketoconazole in the following 2 years.. Amongst the 15 patients treated with topical drugs, 7 (46.7%) had complete remission, 2 (13.3%) had partial response, 4 (26.7%) remained stationary, and 2 (13.3%) died. Out of the 14 cases treated with systemic drugs, 11 (78.6%) had complete remission, 2 (14.3%) had partial response, and 1 (7.1%) died.

Topics: Acquired Immunodeficiency Syndrome; Administration, Topical; Adolescent; Adult; Aged; AIDS-Related Opportunistic Infections; Antifungal Agents; Candidiasis, Oral; CD4 Lymphocyte Count; Female; HIV Infections; HIV Seropositivity; Humans; Immunocompromised Host; Ketoconazole; Male; Middle Aged; Mouthwashes; Nystatin; Treatment Outcome

The aim of this study was to identify in vitro and in vivo activity of Melaleuca alternifolia oil mixed with different tissue conditioners on the Candida albicans strain.. Microbiological tests were used to isolate Candida albicans from patients with denture stomatitis. The in vitro antifungal activity of Melaleuca alternifolia against Candida albicans was determined when it was applied directly and when it was mixed with tissue conditioners (Fitt, Lynal, Coe-Comfort). The responses of 27 denture stomatitis patients treated with Melaleuca alternifolia mixed with Coe-Comfort (n = 9), Nystatin mixed with Coe-Comfort (n = 9), and Coe-Comfort (Control Group, n = 9), were evaluated over a period of 12 days.. In the in vitro study, Coe-Comfort or Fitt conditioners mixed with 1 mL, 20% (vol/vol) of Melaleuca alternifolia oil exhibited a total inhibition of Candida albicans. Patients treated with M. alternifolia mixed with Coe-Comfort showed a significant decrease in palatal inflammation compared with those treated with Coe Comfort (P = .001). In addition, a significant inhibition of C. albicans growth was observed with M. alternifolia mixed with Coe-Comfort compared with only Coe-Comfort (P = .000004).. M. alternifolia oil mixed with Coe-Comfort tissue conditioner is effective in treating denture stomatitis.

Topics: Acrylic Resins; Aged; Antifungal Agents; Candida albicans; Candidiasis, Oral; Colony Count, Microbial; Denture, Complete; Drug Combinations; Female; Humans; Male; Melaleuca; Middle Aged; Nystatin; Phthalic Acids; Phytotherapy; Stomatitis, Denture; Tea Tree Oil; Tissue Conditioning, Dental

The effectiveness of amphotericin B oral suspension versus nystatin oral suspension for the prevention of oral colonization by Candida in hematopoietic cell transplant (HCT) patients was examined.. Prior to hematopoietic cell infusion, 40 patients receiving systemic fluconazole for prophylaxis were randomized to receive either amphotericin B oral suspension or nystatin oral suspension, q.i.d. The study continued to day 21 or until the patient was discharge from the hospital or withdrawn from the study. Oral examinations were conducted twice weekly, and adverse events and compliance were recorded. Cultures were taken for quantitative counts and species identification. Candida isolates were assessed for resistance to the oral antifungal agents. Blood was collected for assessment of amphotericin B levels.. Ulcerative mucositis occurred in 84.6% of patients undergoing HCT, and no correlation was observed between the severity of mucositis and the presence of oral Candida and the severity of mucositis. Systemic and topical antifungal treatment resulted in a decrease in the number of colonized patients (54.8% before treatment; 23.1% during treatment); however, oral colonization was not eliminated. Tolerability of the oral rinse products was limited, with greater noncompliance in the amphotericin B than the nystatin group. Reports of altered taste appeared to be greater in the amphotericin B group. Minimal absorption of amphotericin B was seen following oral rinsing (serum levels 0.12-0.50 microg/ml), and no consistent changes in organism susceptibility to polyenes were seen. The results suggest that topical antifungal rinses may further control oropharyngeal colonization by Candida in patients on systemic antifungals receiving HCT, but the effect is limited by tolerability and reformulation and should be considered in order to increase compliance.

Topics: Administration, Oral; Adolescent; Adult; Aged; Amphotericin B; Antibiotic Prophylaxis; Antifungal Agents; Candidiasis, Oral; Female; Fluconazole; Gingivitis, Necrotizing Ulcerative; Hematopoietic Stem Cell Transplantation; Humans; Male; Middle Aged; Mouth; Mouthwashes; Nystatin; Polyenes; Severity of Illness Index; Time Factors; Treatment Outcome

Oral thrush is a common condition in young infants. Nystatin treatment is associated with frequent recurrences and difficulty in administration. Fluconazole was compared with nystatin for the treatment of oral candidiasis in infants. Thirty-four infants were randomized to either nystatin oral suspension four times a day for 10 days or fluconazole suspension 3 mg/kg in a single daily dose for 7 days. Clinical cures for nystatin were 6 of 19 (32%), and those for fluconazole were 15 of 15 (100%), P < 0.0001. In this small pilot study fluconazole was shown to be superior to nystatin suspension for the treatment of oral thrush in otherwise healthy infants.

Topics: Administration, Oral; Analysis of Variance; Antifungal Agents; Candidiasis, Oral; Dose-Response Relationship, Drug; Drug Administration Schedule; Female; Fluconazole; Follow-Up Studies; Humans; Infant; Infant, Newborn; Male; Nystatin; Probability; Prospective Studies; Treatment Outcome

This study investigated the influence of nystatin and fluconazole on virulence properties of Candida albicans.. A total of 108 diabetic patients participated in the study. Eighty-eight patients had clinical oral candidosis. Drug therapy was given at 6 hourly intervals for nystatin or daily with fluconazole for a maximum of 2 weeks. Adhesion of C albicans to buccal epithelial cells was determined by using an autologous adhesion assay prospectively over 6 months. Phospholipase production was estimated by using an agar plate method. The data analysis included a paired Student t test and calculation of correlation coefficients.. Unlike nystatin, treatment with fluconazole reduced the ability of C albicans to colonize the buccal mucosa for up to 8 weeks after the treatment. Patients without clinical signs of oral candidosis had significantly fewer C albicans isolates producing phospholipase than did patients with oral candidosis. Treatment with fluconazole, but not nystatin, reduced the production of phospholipase from C albicans oral isolates in patients with diabetes mellitus.. In addition to being antifungal, fluconazole alters phospholipase production, modifies buccal epithelial cells, and reduces adhesion of C albicans to human buccal epithelial cells for up to 8 weeks posttreatment in diabetic patients with oral candidosis.

Topics: Analysis of Variance; Antifungal Agents; Bacterial Adhesion; Candida albicans; Candidiasis, Oral; Chi-Square Distribution; Diabetes Mellitus, Type 1; Epithelial Cells; Female; Fluconazole; Humans; Male; Middle Aged; Nystatin; Phospholipases; Prospective Studies; Virulence

In order to substantiate a previous case report of a drug interaction between tacrolimus and clotrimazole, we randomly assigned tacrolimus-treated renal allograft recipients to therapy with either clotrimazole or nystatin for oral thrush prophylaxis immediately following transplantation. Patients receiving other agents known to interact with cytochrome P450 were excluded from the study. The clotrimazole group consisted of 17 patients and the nystatin group, which served as the control group, consisted of 18 patients. An oral loading dose (approximately 0.3 mg/kg) of tacrolimus was given pre-operatively. Post-transplant, tacrolimus (approximately 0.15 mg/kg) was orally administered twice daily. Clotrimazole therapy consisted of a 10-mg troche administered three times daily. Nystatin therapy consisted of the oral suspension (5 mL) administered as a 'swish and swallow' four times daily. We evaluated tacrolimus trough blood levels and tacrolimus doses on days 1, 3, 5, and 7 following transplantation. On post-transplant day 1, mean tacrolimus trough levels did not differ between clotrimazole- and nystatin-treated patients. Mean tacrolimus blood trough levels were significantly higher in clotrimazole-treated patients on days 3, 5, and 7 post-transplant, 42+/-14, 53+/-7, and 33+/-17 ng/mL, respectively, compared to 15+/-8, 15+/-7, and 14+/-6 ng/mL in nystatin-treated patients (p<0.05). The mean tacrolimus dose was significantly lower in the clotrimazole group by day 7 post-transplant (p<0.05). We conclude that clotrimazole therapy may cause a significant rise in tacrolimus trough blood levels. Recognition of this potential drug interaction is essential to minimize tacrolimus-associated toxicities in the early post-transplant period.

Topics: Adult; Antifungal Agents; Candidiasis, Oral; Clotrimazole; Drug Interactions; Humans; Immunosuppressive Agents; Kidney Transplantation; Nystatin; Prospective Studies; Tacrolimus

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.

Topics: Administration, Oral; Adult; Aged; Antifungal Agents; Candidiasis, Oral; Capsules; Dentures; Erythema; Female; Fluconazole; Follow-Up Studies; HIV Infections; Humans; Immunosuppression Therapy; Male; Middle Aged; Mouth Mucosa; Mouthwashes; Nystatin; Organ Transplantation; Patient Compliance; Patient Satisfaction; Recurrence; Risk Factors; Xerostomia

Multilocus enzyme electrophoresis (MEE) and in vitro antifungal susceptibility testing were used to investigate the Candida albicans strain diversity in twenty nine AIDS patients from Abidjan (Ivory Coast). All patients were monitored for a first episode of oropharyngeal candidiasis and were randomly clustered into three groups of therapy: ketoconazole, amphotericin B or nystatin. Oral swabs were collected before every treatment, 14 and 30 days after the initiation of the therapy; a total of 67 isolates were investigated. No resistant or less susceptible isolate to any antifungal agent was found despite the emergence of clinical relapses, mainly for patients treated with nystatin or amphotericin B. The MEE analysis revealed 27 different electrophoretic types (ETs). Genetic distances between ETs were statistically analyzed and represented on a dendrogram. The 27 ETs clustered into three groups; in each group, ETs represented variants of the same strain. A segregation of the C. albicans isolates seemed to be as a function of the serotype.

Topics: Adult; AIDS-Related Opportunistic Infections; Amphotericin B; Antifungal Agents; Candida albicans; Candidiasis, Oral; Cote d'Ivoire; Drug Resistance, Microbial; Fungal Proteins; Genetic Variation; Humans; Ketoconazole; Middle Aged; Nystatin; Phylogeny; Treatment Outcome

Topics: Administration, Oral; Adolescent; Adult; Antifungal Agents; Candidiasis, Oral; HIV Infections; Humans; Middle Aged; Nystatin; Sodium Benzoate

The present study involves the analysis of some saliva components (SC) and serum components in patients with oral candidosis topically treated with Ketoconazole 2% (K) or Nystatin 100,000 IU (N). Twenty-four male and female patients, age range 39-82 years, were included in the study. A double-blind study was undertaken in which the patients were divided into 2 treatment groups. These groups were compared with a control group (CG) of 16 healthy patients, both male and female, age-matched with the treated groups. The parameters evaluated were oral mucous membrane lesion index (MLI), CFU of Candida, saliva flow rate, protein-bound Fe (Fe-prot), Fe-prot binding capacity (Fe-prot cap), IgAs, peroxidase activity (PA), hypothiocyanite and thiocyanite. The values of Candida CFU and MLI were significantly reduced in patients treated with K and N. The pre-treatment values of SC as compared to the CG revealed a reduction in Fe-prot and Fe-prot cap. These parameters reach values similar to control towards the end of the treatment. The PA was significantly higher in candidosis patients and fell to control values with treatment. The other SC and serum components did not exhibit significant differences with the CG. Patients with oral candidosis treated locally exhibit not only an improvement in clinical manifestations but also a return to control values of altered SC.

Topics: Administration, Topical; Adult; Aged; Aged, 80 and over; Analysis of Variance; Antifungal Agents; Candidiasis, Oral; Double-Blind Method; Female; Humans; Iron; Ketoconazole; Male; Middle Aged; Mouth Mucosa; Nystatin; Peroxidase; Protein Binding; Saliva; Thiocyanates; Treatment Outcome

Miconazole gel has previously been shown to be an effective treatment for oropharyngeal candidiasis (thrush) in immunocompetent infants. This study compares miconazole gel with the standard therapeutic agent, nystatin suspension, with regard to efficacy, optimal duration of therapy and safety.. Prospective multicenter, randomized, office-based open trial.. Twenty-six pediatricians enrolled 227 immunocompetent infants with signs of oropharyngeal thrush. Subjects were randomly assigned to receive 25 mg of miconazole as oral gel four times daily or 100,000 IU of nystatin as suspension four times daily after meals. All subjects were evaluated for safety. Fifteen patients whose thrush was not confirmed by culture were excluded from further analysis. The remaining 212 subjects were entered into an intention-to-treat analysis. Another 29 patients violated the study protocol; the remaining 183 subjects were evaluated for efficacy (per protocol analysis).. Clinical cure by Day 5 of treatment was demonstrated in 84.7% of the 98 subjects in the miconazole group and 21.2% of the 85 subjects in the nystatin group (P < 0.0001). By Day 8, the cumulative clinical cure rates were 96.9% (miconazole) and 37.6% (nystatin), respectively (P < 0.0001). By Day 12.99.0% of subjects in the miconazole group and 54.1% of subjects in the nystatin group were clinically cured (P < 0.0001). Premature cessation of treatment at parents' request because of lack of clinical efficacy occurred in none of the infants treated with miconazole and in 6 infants treated with nystatin (P = 0.029). The oral yeast eradication rate on Day 5 was 54.1% with miconazole and 8.2% with nystatin (P < 0.0001). Clinical relapses of oropharyngeal thrush and side effects of the study drugs were observed with similar frequency in both study arms.. Miconazole gel was significantly superior to nystatin suspension with regard to efficacy, rapidity of achieving cure and oropharyngeal yeast eradication. Relapses and side effects did not occur more frequently with miconazole than with nystatin. The results of this study indicate that miconazole gel is superior to nystatin suspension as the treatment for oropharyngeal candidiasis in immunocompetent infants.

Topics: Antifungal Agents; Candidiasis, Oral; Female; Gels; Humans; Immunocompetence; Infant; Male; Miconazole; Nystatin; Prospective Studies; Suspensions

A total of 167 human immunodeficiency virus (HIV)-infected patients with oropharyngeal candidiasis were randomly assigned to receive 14 days of therapy with liquid suspension fluconazole (100 mg once daily) or liquid nystatin (500,000 U four times daily). At day 14, 87% of the fluconazole-treated patients were clinically cured, as opposed to 52% in the nystatin-treated group (P < .001). Fluconazole eradicated Candida organisms from the oral flora in 60%, vs. a 6% eradication rate with nystatin (P < .001). The fluconazole group had fewer relapses noted on day 28 (18%, vs. 44% in the nystatin group; P < .001). This relapse difference no longer existed by day 42. Fluconazole oral suspension as a systemic therapy was more effective than liquid nystatin as a topical therapy in the treatment of oral candidiasis in HIV-infected patients and provided a longer disease-free interval before relapse.

Topics: Adult; AIDS-Related Opportunistic Infections; Antifungal Agents; Candidiasis, Oral; Fluconazole; Humans; Nystatin; Pharyngeal Diseases; Suspensions

To determine whether daily use of nystatin pastilles can prevent initial outbreak or recurrence of oral candidiasis in HIV-infected patients and to identify factors associated with outbreaks during 20-week follow-up, a randomized, double-blind, placebo-controlled clinical trial was conducted. Subjects were 128 HIV-infected men (aged 27-60 years) who either had had no documented episode of oral candidiasis in the previous year or had been clinically clear of oral candidiasis for at least 72 h before randomization. Study arms were two placebo pastilles, one nystatin (200,000 U) and one placebo pastille, or two nystatin pastilles daily for 20 weeks. The main outcome measure was time to oral candidiasis, as determined by potassium hydroxide (KOH) smear and fungal culture. A multivariate proportional hazards model showed that four factors were significant (p < 0.001) in predicting time to oral candidiasis: nystatin treatment (hazard ratio 0.59), history of oral candidiasis (3.58), Candida albicans carriage (2.79), and CD4 count at randomization (0.65). In this small group of subjects, nystatin appeared to be effective in delaying onset of oral candidiasis. Patients with CD4 counts < 200 who are carriers of C. albicans and have a history of oral candidiasis may be most likely to benefit from antifungal prophylaxis.

Topics: Adult; AIDS-Related Opportunistic Infections; Antifungal Agents; Candidiasis, Oral; CD4 Lymphocyte Count; Double-Blind Method; Humans; Male; Middle Aged; Nystatin; Proportional Hazards Models

Oral candidal infection is a common problem in bone marrow transplantation. This prospective study compared the effectiveness of antifungal prophylaxis with topical antifungals (nystatin and amphotericin B suspensions) versus oral fluconazole in 196 patients undergoing bone marrow transplantation. Oral candidosis occurred frequently in the group receiving topical antifungals (61/113, 54%), but was rare in the group receiving fluconazole (6/83, 7%). The difference in efficacy between the two groups was highly significant (p < 0.00001). There was no difference in the incidence of suspected systemic fungal infection between the two groups. While nausea was a problem with antifungal suspensions, no significant adverse reactions to fluconazole occurred. Because of greater efficacy in preventing oral candidosis and better patient tolerance, oral fluconazole is preferred to antifungal suspensions for prophylactic use in patients undergoing bone marrow transplantation.

Topics: Administration, Oral; Adolescent; Adult; Amphotericin B; Antibiotic Prophylaxis; Antifungal Agents; Bone Marrow Transplantation; Candidiasis, Oral; Child; Drug Combinations; Fellowships and Scholarships; Female; Fluconazole; Humans; Male; Middle Aged; Mouthwashes; Nystatin; Prospective Studies; Retrospective Studies

To compare the efficacy, safety, and tolerance of fluconazole suspension versus nystatin in the treatment of oropharyngeal thrush in immunocompromised children.. Multicenter, randomized, observer-masked trial.. Thirty-two centers participated, including hospitals and ambulatory care clinics.. We enrolled 182 immunocompromised infants and children, ages 5 months to 14 years, with signs of oral thrush and presence of yeasts on potassium hydroxide- or gram-stained preparations. Subjects were randomly assigned to receive a single daily dose of fluconazole suspension, 2 to 3 mg/kg per day, or nystatin, 400,000 units four times daily for 14 days; 159 patients, who had culture confirmation of thrush and received at least 7 days of study drug, were evaluated for efficacy; all patients were evaluated for safety.. Clinical cure was demonstrated in 91% of the subjects in the fluconazole group and 51% of the subjects in the nystatin group (p < 0.001), and eradication of the organism cultured at entry occurred in 76% and 11% (p < 0.001), respectively. Gastrointestinal conditions developed in six patients who received fluconazole and in three who received nystatin; two fluconazole recipients were subsequently withdrawn from the study. Laboratory abnormalities occurred with equal frequency in both groups. Clinical relapse rates were similar in both groups at 2 weeks (18% and 24% for fluconazole and nystatin, respectively) and 1 month (28% and 27%, respectively) after the completion of study drug.. Fluconazole suspension is more effective than nystatin in the treatment of thrush in immunocompromised children. Both regimens were well tolerated.

Topics: Administration, Oral; Adolescent; Candidiasis, Oral; Child; Child, Preschool; Double-Blind Method; Drug Administration Schedule; Fluconazole; HIV Infections; Humans; Immunocompromised Host; Immunosuppression Therapy; Infant; Neoplasms; Nystatin; Recurrence

Because of predisposing systemic disease, the frequent administration of medication, and the use of a complete denture, oral candidiasis is a common problem among older, chronically ill, institutionalized adults. This randomized clinical trial was designed to evaluate the effectiveness of an antifungal denture soaking solution (48 mL nystatin liquid, 100,000 IU/mL, dissolved in 432 mL of distilled water producing 10,000 IU nystatin mL solution), used as an adjunct to a nystatin vaginal lozenge (100,000 IU/g, dissolved in the mouth three times daily for seven days) in a group of older, chronically ill, institutionalized adults. Although the clinical signs and symptoms of oral candidiasis were resolved in all subjects following therapy, the presence of invasive Candida hyphae was detected in approximately 80 per cent of tissue and/or dentures. When compared to tap water, the use of an antifungal denture soaking solution produced no detectable difference in the presence of Candida albicans hyphae over a three-month period (M-H chi-square = 0.021, p = 0.886), but it did reduce the rate of recurrence of clinical signs and symptoms. The appropriateness of this regimen for the treatment of oral candidiasis in this type of patient is challenged.

Topics: Aged; Candidiasis, Oral; Chi-Square Distribution; Dental Care for Aged; Denture Cleansers; Denture, Complete, Upper; Female; Humans; Life Tables; Male; Nursing Homes; Nystatin

The goal of reducing oral complications during chemotherapy and bone marrow transplantation has received attention at several centers. The current randomized study of 86 adults with leukemia treated with chemotherapy or bone marrow transplantation assessed the potential role of chlorhexidine, nystatin, and saline solution rinses to reduce the findings of oral mucositis, gingivitis, and oral infection. The results of this study did not show a reduction in mucositis with the use of these rinses. However, potential bacterial and fungal pathogens were identified less frequently in the patients using chlorhexidine rinse.

Topics: Adolescent; Adult; Aged; Antineoplastic Agents; Bacteremia; Bacteria; Bone Marrow Transplantation; Candidiasis, Oral; Chlorhexidine; Drug Combinations; Female; Humans; Leukemia; Leukemia, Myeloid, Acute; Male; Middle Aged; Mouth Diseases; Mouthwashes; Nystatin; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Stomatitis; Ulcer; Whole-Body Irradiation

A prospective randomized study was conducted to assess the effectiveness of clotrimazole troches and nystatin suspension to prevent oral candidiasis in immunosuppressed orthotopic liver transplant patients. Thirty-four patients received either clotrimazole troches, 10 mg, five times daily, or nystatin suspension, 500,000 units, four times daily. Prophylaxis was initiated after extubation after transplantation and continued throughout the hospitalization. One of 17 patients in each treatment group developed clinical and microscopic evidence of an oropharyngeal Candida infection. This gave an intragroup and an overall infection rate of 5.9%. It appears that either nystatin or clotrimazole may be used for candidiasis prophylaxis in orthotopic liver transplant patients.

Topics: Administration, Oral; Adolescent; Adult; Candidiasis, Oral; Child; Child, Preschool; Clotrimazole; Female; Humans; Immunocompromised Host; Incidence; Liver Transplantation; Male; Middle Aged; Nystatin; Prospective Studies; Random Allocation; Treatment Outcome

A randomized un-blinded study on the treatment of oropharyngeal and esophageal candidiasis was conducted in Kinshasa (Zaire), among 141 inpatients with AIDS and oropharyngeal candidiasis, of whom 136 also had esophageal candidiasis. The study compared the efficacy of gentian violet mouth washes (1.5 ml 0.5% aqueous solution b.i.d.), oral ketoconazole (200 mg/day, after a meal) and nystatin mouth washes (200.000 U oral suspension q.i.d.). Patients treated with mouth washes swallowed their medication after mouth washing. Patients enrolled in this study had a very high mortality (probability of death: 41.6% after 14 days). After 14 days, 72 patients could be evaluated. At that time, oropharyngeal lesions had disappeared in similar proportions of patients treated with gentian violet (11/26, 42%) and ketoconazole (10/23, 43%), and in a lower proportion of patients treated with nystatin (2/23, 9%; p less than 0.05). In esophageal candidiasis, ketoconazole seemed more efficient than both other treatments: esophageal lesions had disappeared in 5 (24%) of the 21 patients on ketoconazole, compared to less than 10% of patients on both other treatments (p = 0.07). The suboptimal results observed with all 3 treatments could be explained by the profound immunosuppression of patients enrolled in the study. This study suggests that gentian violet is effective treatment for oropharyngeal candidiasis. As it is very cheap (0.5 US$/treatment course in Kinshasa), we suggest that its use should be assessed in larger studies.

Topics: Acquired Immunodeficiency Syndrome; Adult; Candidiasis, Oral; Democratic Republic of the Congo; Female; Gentian Violet; Humans; Ketoconazole; Male; Nystatin

Nystatin has been formulated in the form of a flavored pastille (troche) as an alternative to the oral suspension. This parallel, double-blind, randomized, placebo-controlled study evaluated the acceptance and effectiveness of the nystatin pastille at two different dosages. Twenty-four subjects were selected on the basis of clinical signs of denture stomatitis and culture isolation of Candida spp. Each subject was randomly assigned to one of three treatment groups (A, 200,000 units; B, 400,000 units; and C, placebo). At entry, 7 days, 14 days, and at 10 days after cessation of treatment, the clinical condition was evaluated and Gram stain smears and imprint cultures were made and analyzed. The flavored pastille was well accepted by the subjects and both dosages were shown to be effective in significantly reducing or eliminating the Candida organism during active therapy. Data from the 10-day follow-up, however, demonstrated reinfection with the organism. Thus to resolve the condition, effective therapy must include treatment of the etiologic factors of denture stomatitis along with antimicrobial therapy.

Topics: Candidiasis, Oral; Clinical Trials as Topic; Double-Blind Method; Humans; Nystatin; Random Allocation; Stomatitis; Stomatitis, Denture; Tablets

Topics: Adolescent; Adult; Agranulocytosis; Candidiasis, Oral; Clotrimazole; Female; Humans; Imidazoles; Male; Middle Aged; Neutropenia; Nystatin

An open study designed to compare the effectiveness and safety of clotrimazole troches with nystatin oral suspension in the prevention of oropharyngeal candidiasis was conducted. This study was performed as the troche form of clotrimazole was easier to administer and less costly than nystatin oral suspension. Sixty assessable patients were randomized to receive either clotrimazole troches (n = 32) or nystatin oral suspension (n = 28) for a 60-day period after receiving a renal allograft. The two groups were comparable in age, sex, type of transplant, and amount of immunosuppression. Both regimens were 100% effective in preventing the development of thrush in the patients studied. Adverse effects were infrequently seen in either group (one case of mild nausea in the clotrimazole group and three cases in the nystatin group). One patient chose to withdraw from the clotrimazole group, and eight patients withdrew from the nystatin group before completing 60 days of therapy (P = .002). Reasons given for withdrawal were the unpleasant taste of the drugs, or an inability to comply with the protocol. The cost of clotrimazole troches in the prophylactic doses given in this study was approximately one tenth that of nystatin oral suspension. Clotrimazole troches are effective, less expensive, and easier to self-administer than nystatin oral suspension.

Topics: Administration, Topical; Adolescent; Adult; Aged; Candidiasis, Oral; Clotrimazole; Female; Humans; Imidazoles; Immunosuppressive Agents; Kidney Transplantation; Male; Middle Aged; Nystatin; Pharyngeal Diseases; Postoperative Complications; Prospective Studies; Random Allocation; Suspensions; Tablets

A randomized trial was conducted comparing ketoconazole and nystatin in the prevention of oral candidiasis and appearance of invasive fungal infections in 51 neutropenic leukemic patients undergoing induction chemotherapy. Ketoconazole was administered in a 200 mg dose twice daily. Nystatin oral suspension was given in doses of 500,000 units four times daily. Surveillance cultures of the throat and urine were obtained prior to treatment and conducted weekly. Patients were enrolled in the study if the absolute granulocyte count was less than 1500/microliter, if physical examination revealed no evidence of oral candidiasis, no evidence of urinary tract infection, and there was no pulmonary infiltrate on chest x-ray. Patients were continued on study until the absolute granulocyte count reached 1500/microliter, evidence of oral candidiasis appeared, or presumed or proven invasive fungal infections appeared. Of the 46 evaluable patients, 22 received ketoconazole, 3 (14%) developed oral candidiasis, and 5 developed suspected systemic fungal infections (23%). Of 24 patients who received nystatin, 4 (17%) developed oral candidiasis and 8 (33%) developed systemic fungal infections, 4 proven and 4 suspected. Significantly more patients on the nystatin arm progressed to invasive fungal infections. Ketoconazole was not superior to nystatin in reducing the frequency of oral candidiasis but possibly reduced the frequency of invasive fungal infections.

Topics: Acute Disease; Adolescent; Adult; Aged; Agranulocytosis; Candidiasis, Oral; Female; Humans; Immune Tolerance; Ketoconazole; Leukemia; Male; Middle Aged; Neutropenia; Nystatin; Random Allocation

Fifty consecutive patients with respiratory diseases who developed oropharyngeal candidiasis were assessed clinically and microbiologically before and after seven days' treatment with nystatin suspension or pastilles (a new formulation). In 45 patients in whom microbiology yielded positive results there was frequent associated use of oral corticosteroids, antibiotics, sedatives, and inhaled corticosteroid, while in a few patients atropine analogues may have predisposed to infection. Dentures were worn by 32 of the infected patients. Concomitant treatment of dentures in chronically infected patients appeared to improve the therapeutic response. Pastilles and suspension were equally efficacious both clinically and microbiologically. The potential for enhanced drug delivery to the oropharynx suggests that nystatin pastilles may be useful in patients in whom poor compliance seems likely.

Topics: Administration, Oral; Adolescent; Adult; Aged; Anti-Bacterial Agents; Candidiasis, Oral; Dentures; Female; Humans; Male; Middle Aged; Nystatin; Respiratory Tract Diseases; Respiratory Tract Neoplasms; Steroids; Tablets

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.

Topics: Adolescent; Candidiasis, Oral; Child; Child, Preschool; Clinical Trials as Topic; Female; Gels; Humans; Infant; Male; Miconazole; Nystatin; Patient Compliance; Prospective Studies; Suspensions

Sixty-seven asthmatic individuals treated with either beclomethasone diproprionate or flunisolide were sequentially evaluated for up to 32 months to determine the incidence of oropharyngeal candidiasis as well as laboratory parameters which might be predictive of this complication. Throat cultures and measurements of Candida antibody by immunodiffusion and radioimmunoassay were performed and compared over time and treatment groups. Unlike other studies, pre-treatment Candida precipitins did not predict increased risk for clinical thrush nor did quantitative determinations of Candida antibody. Those patients with positive cultures pre-trial, however, had a significantly higher incidence of clinical thrush than those with negative cultures (P less than 0.01). No significant changes occurred over time or between drugs for any of the parameters. Symptomatic thrush, however, was slightly more common in those patients treated with beclomethasone.

Topics: Adolescent; Adult; Aerosols; Aged; Antibodies, Fungal; Asthma; Beclomethasone; Binding Sites, Antibody; Candida; Candidiasis, Oral; Female; Fluocinolone Acetonide; Humans; Male; Middle Aged; Nystatin; Risk

Topics: Adrenal Cortex Hormones; Aerosols; Asthma; Beclomethasone; Candidiasis; Candidiasis, Oral; Dose-Response Relationship, Drug; Female; Humans; Male; Middle Aged; Nystatin; Respiratory Tract Infections; Time Factors; Voice Disorders

Fifty-six untreated patients with acute leukemia (38 acute myelogenous leukemia, 16 acute lymphoblastic leukemia, and 2 blast crisis of chronic granulocytic leukemia) were randomized on admission to one of three groups--one to receive oral anticandidal prophylaxis through the period of remission induction chemotherapy with nystatin, another to receive natamycin, and the third to receive no anticandidal prophylaxis. Neither of the first two groups show any advantage over the last and it is concluded that provided gut sterilization regimes are not employed, prophylactic oral anticandidal treatment is of no value in these patients and should be reserved until there is clinical evidence of infection.

Topics: Administration, Oral; Antineoplastic Agents; Candidiasis; Candidiasis, Oral; Drug Evaluation; Humans; Leukemia, Lymphoid; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Natamycin; Nystatin

A double-blind trial of nystatin, amphotericin B, and a placebo was carried out in fifty-two cases of denture-related candidiasis and/or angular cheilitis. The drugs effected a significant clinical cure, but recurrence of the signs was common after withdrawal of the drugs. Concurrent bacteriologic examination showed few cures and continued presence of Candida albicans during the trial. A specimen from a red palate was examined histologically.

Topics: Amphotericin B; Blood Vessels; Candida albicans; Candidiasis, Oral; Cheilitis; Denture, Complete, Upper; Epithelium; Humans; Nystatin; Palate; Placebos; Stomatitis; Stomatitis, Denture

Topics: Birth Weight; Candidiasis, Oral; Clinical Trials as Topic; Clotrimazole; Humans; Imidazoles; Infant, Newborn; Infant, Newborn, Diseases; Nystatin; Recurrence

Topics: Adult; Aged; Candida; Candidiasis; Candidiasis, Cutaneous; Candidiasis, Oral; Clinical Trials as Topic; Female; Humans; Male; Middle Aged; Nystatin; Penicillin G; Rectal Diseases; Tetracycline

Phytotherapeutics is widely used nowadays as an alternative to the current antifungal drugs to reduce their side effects. Curcumin, with its wide therapeutic array as antioxidant and anti-inflammatory agent, is one of the natural compounds that ha..s an antifungal effect, especially when being used at nanoscale to increase its bioavailability. Our research aimed to evaluate clinically and microbiologically the effect of using topical nanocurcumin suspension to treat oral candidiasis. After 4 days from induction of oral candidiasis (baseline), we randomly divided 39 female BALB/c mice into three groups of 13 animals; nanocurcumin, nystatin, and sham groups. All animals in nanocurcumin and nystatin groups received topical treatment twice daily for 10 days. Then, we performed clinical and microbiological evaluations at baseline, day 5, and day 10. By the end of treatment, our results revealed that nanocurcumin promoted a significant reduction in the number of candida colonies. There was no statistically significant difference neither clinically nor microbiologically between nanocurcumin and nystatin groups. In conclusion, nanocurcumin has a good antifungal effect as nystatin, however, its therapeutic efficacy takes a longer time to appear than nystatin. The enhanced bioavailability of curcumin at the nanoscale qualifies this nano-herb as a promising alternative therapy for oral candidiasis, evading nystatin-associated morbidity.

Topics: Animals; Antifungal Agents; Candidiasis, Oral; Curcumin; Female; Mice; Nanoparticles; Nystatin

To investigate antifungal and mechanical properties after the impregnation of Dimethyl Amino-ethyl Hexa-decyl Di-methacrylate (DMAHDM) alone or in combination with Nystatin in polymethylmethacrylate.. The control group was fabricated by mixing powder and liquid of PMMA at the ratio of 2.5:1 g/mL. The DMAHDM was added to PMMA liquid and were mixed with PMMA powder. The Nystatin (500,000 International Units (IU)) was mixed with PMMA powder, whereby the composite powder was mixed with the DMAHDM-based liquid. The prepared specimens were tested for fungal adhesion testing (at days 1 and 30), impact strength and flexural strength. Oneway ANOVA post-hoc Tukey's test were used for statistical analysis.. Statistical analysis for the adhesion assay revealed that the antifungal activities of unaged and aged specimens in experimental groups were statistically significant as compared to control group A. The groups containing DMAHDM with Nystatin have shown statistically reduced flexural strength. The impact strength test revealed that groups containing 20% DMAHDM alone and DMAHDM with Nystatin showed statistically reduced impact strength compared to the control group.. Antifungal activities of experimental PMMA resin was increased. The addition of DMAHDM alone in PMMA resin has no deleterious effects on impact and flexural strength, however, at higher concentration values were reduced.

Topics: Acrylic Resins; Antifungal Agents; Candidiasis, Oral; Humans; Methacrylates; Nystatin; Polymethyl Methacrylate; Powders; Stomatitis, Denture; Surface Properties

Hyperplastic candidiasis (HC) is a chronic infection of oral mucosa caused by Candida. Owing to its potential for malignant transformation, its intervention requires attention. Conventional surgical resection might lead to irreversible damage and impact the patient's quality of life. Hence, this study aimed to evaluate the clinical efficacy of 5-aminolevulinic acid (5-ALA)-mediated photodynamic therapy (PDT) alone and in combination with topical antifungal therapy (i.e., nystatin [combination therapy]) in comparison with nystatin and surgical resection for the treatment of HC.. Forty subjects with clinical and histopathological diagnoses of HC were included in the study. Four study groups, with 10 participants each, were formed as follows: Group-I - receiving antifungal agent [nystatin]; Group-II - receiving surgical resection; Group-III - receiving PDT; and Group-IV - receiving 5-ALA-mediated PDT and nystatin [combination therapy]. Salivary and mucosal samples were collected for the quantification of Candida albicans and the treatment responses to different interventions were recorded at week-4, week-6, and week-8 after finishing therapies.. The application of 5-ALA-mediated PDT in combination with nystatin gel possesses the potential as a well-tolerated and safe therapeutic modality for the treatment of patients with HC.

Topics: Aminolevulinic Acid; Antifungal Agents; Candida albicans; Candidiasis, Oral; Humans; Nystatin; Photochemotherapy; Photosensitizing Agents; Quality of Life; Treatment Outcome

The effectiveness of antifungal agents may be insufficient against resistant strains in some cases of oral candidiasis. The aim of this study was to evaluate the antifungal effect of thymoquinone against Candida albicans, Candida tropicalis, Candida glabrata and Candida krusei strains and the synergistic antifungal activity of these strains in combination with nystatin. To evaluate in vitro antifungal activity and interactions between thymoquinone and nystatin, substances were tested against Candida albicans ATCC 10,231, C. tropicalis ATCC 750, C.krusei ATCC 6258 and C. glabrata ATCC 2001 standard strains both individually and combinationally via microdilution method. MIC and ΣFIC index value were analysed. The Kruskal Wallis test and Bonferroni test were used for statistical evaluations. Statistical significance was set at p < 0.05. A statistically significant difference was observed between the mean ranks of all Candida species and doses of thymoquinone, nystatin, and the combination thymoquinone-nystatin (p < 0.05). MIC values for thymoquinone were determined as 15 μg/mL for C. albicans, C. tropicalis and C. krusei while it was 30 μg/mL for C. glabrata. Moreover, MIC for nystatin was found as 1.875 μg/mL for C. albicans, C. tropicalis and C. krusei, whereas it was 7.5 μg/mL in C. glabrata. Interaction assays and ΣFIC index value revealed that, TQ and nystatin have a synergistic effect against to all strains. Thymoquinone was found to have antifungal activity on Candida species and synergistic effect when combined with nystatin.

Topics: Antifungal Agents; Benzoquinones; Candida; Candidiasis, Oral; Microbial Sensitivity Tests; Nystatin

Oral candidiasis is a fungal infection caused mainly by Candida albicans and it is a major problem among hematologic malignancy patients. Biofilm formation is an attributable factor to both virulence and drug resistance of Candida species. The aim of the study was to evaluate the biofilm-producing ability of oral C. albicans isolates and to evaluate the inhibitory activity of eucalyptol on Candida biofilm, alone and in combination with antifungal agents. Samples were collected from the oral cavity of 106 patients with hematologic malignancy. The isolated yeasts were identified by PCR-sequencing. Then C. albicans isolates were analyzed for their biofilm-producing ability by crystal violet staining and MTT assay. The minimum biofilm inhibition concentrations (MBIC) of eucalyptol, amphotericin B, itraconazole, and nystatin and the in vitro interaction of eucalyptol with these drugs were tested according to CLSI-M-27-A3 protocol and checkerboard methods, respectively. From 106 patients, 50 (47.2%) were confirmed for oral candidiasis [mean ± SD age 39 ± 14 years; female 31 (62%) and male 19 (38%)]. C. albicans was isolated from 40 of 50 (80%) patients. From 40 C. albicans isolates, 24 (60%) and 16 (40%) were moderate and weak biofilm producer, respectively. The geometric mean MBIC of amphotericin B, itraconazole, nystatin and eucalyptol were 3.93 µg/mL, 12.55 µg/mL, 0.75 µg/mL and 798 µg/mL, respectively. Eucalyptol interacted synergistically with amphotericin B, itraconazole and nystatin against 12.5, 10, and 22.5% of isolates, respectively. Eucalyptol demonstrated promising activity against biofilm of C. albicans when tested alone or combined with antifungal drugs.

Topics: Adult; Amphotericin B; Antifungal Agents; Biofilms; Candida; Candida albicans; Candidiasis, Oral; Eucalyptol; Female; Hematologic Neoplasms; Humans; Itraconazole; Male; Microbial Sensitivity Tests; Middle Aged; Nystatin

This study assessed the effects of chitosan (CS) on microcosm biofilms derived from saliva of patients with Candida-associated denture stomatitis.. Five removable denture wearers with denture stomatitis were included in the study. The minimum inhibitory concentration (MIC) of CS against clinical isolates of Candida albicans was determined according to the broth microdilution method. Pooled saliva from the donors was used as an inoculum for the formation of biofilms, which were developed during 72 h on acrylic surfaces in the Amsterdam Active Attachment model. The biofilms were then treated with different concentrations of CS, and the antibiofilm effects were evaluated through the quantification of colony-forming units (CFUs), total biomass (TB), metabolic activity (MA), lactic acid production (LAP), and cell viability (by confocal laser scanning microscopy). Chlorhexidine, miconazole, and nystatin were tested as positive controls, while the negative control (NC) was the untreated biofilm. Data were analyzed by 1-way ANOVA and Fischer LSD's post hoc test (α=0.05).. MIC values of CS ranged from 500 to 800 µg/mL. For CFUs, 2500 µg/mL CS was the most effective treatment in reducing total anaerobes, mutans streptococci, and Lactobacillus spp., significantly differing from the controls. For C. albicans CFUs, CS and positive controls did not differ from each other but led to significant reductions compared to NC. Regarding TB, MA, LAP, and cell viability, 2500 µg/mL CS promoted the greatest reductions compared to NC.. CS has similar or superior effects to conventional active principles on important parameters of oral candidiasis microcosm biofilms.. The antibiofilm effects of CS show that this compound has great potential to improve the clinical condition of denture stomatitis patients, and formulations containing this natural polymer could be useful for controlling oral candidiasis.

Topics: Acrylic Resins; Antifungal Agents; Biofilms; Candida albicans; Candidiasis, Oral; Chitosan; Chlorhexidine; Humans; Lactic Acid; Miconazole; Nystatin; Stomatitis, Denture

Buccal film formulations, including antifungal nystatin, anti-inflammatory agent hydrocortisone acetate, and local anesthetic lidocaine hydrochloride for pain relief, were developed. Bioadhesive films were fabricated with hydrophilic polymers, hydroxyethyl cellulose (HEC), and xanthan gum (XG) and dried in the incubator. Textural, swelling, and bioadhesive properties, physicochemical and in vitro release characteristics, and antifungal activities of bioadhesive films were evaluated.Bioadhesive films significantly extended nystatin release by prolonging retention time of the target area formulation while rapidly releasing hydrocortisone acetate and lidocaine HCl, reducing drug administration. The polymer type affected bioadhesion strength and erosion ratio, and XG formulations had more polymer suitability. Consequently, XT-O2 formulation that was prepared with xanthan gum and tween 80, was best for its highest antifungal film activity (20.00 ± 0.07 mm), released nystatin (44.296% ± 1.695), and lowest erosion matrix (36.719% ± 0.249). The selected formulation can be used for compatibility, stability and in vivo studies targeted oral candidiasis infections.

Topics: Adhesiveness; Administration, Buccal; Antifungal Agents; Candidiasis, Oral; Humans; Mouth Mucosa; Nystatin; Polymers

To compare the incidence of oropharyngeal candidiasis (OC), or thrush, in renal transplant recipients receiving nystatin versus no antifungal prophylaxis.. This was a single-center, retrospective, non-inferiority study of adult renal transplant recipients (RTRs) who received nystatin for 30 days for OC prophylaxis (nystatin group) or no antifungal prophylaxis therapy (No PPX group). The primary outcome was the incidence of OC within 3 months post-transplant. Secondary outcomes included time to OC occurrence and severity of OC. The pre-specified non-inferiority margin was 10%.. The incidence of OC within 3 months post-transplant among 257 RTRs was 7.8% (10/128) in the No PPX group and 4.7% (6/129) RTRs in the nystatin group, a risk difference of 3.2% (95% CI, -2.7% to 9.1%, non-inferiority P = .04). The median time to OC was 7.5 days (IQR 6.3-34.3 days) in the nystatin group and 9.5 days (IQR 5.3-30.5 days) in the No PPX group (P = .64). Esophageal candidiasis was observed in 10% (1/10) of RTRs with OC in the No PPX group compared to 16.7% (1/6) RTRs in the nystatin group (P = 1.00). All RTRs with OC achieved symptom resolution with fluconazole and/or nystatin. Two patients in the No PPX group required readmission for decreased oral intake, and OC was diagnosed and treated during their hospital day.. In this retrospective study of adult RTRs, the absence of antifungal prophylaxis demonstrated non-inferiority to 30-day nystatin prophylaxis at reducing the incidence of OC within 3 months of transplant. OC prophylaxis may not be warranted after renal transplant.

Topics: Antifungal Agents; Candidiasis, Oral; Humans; Kidney Transplantation; Nystatin; Retrospective Studies; Transplant Recipients

The objective of this work was to prepare mucoadhesive buccal tablets containing nystatin and purified cashew gum for the treatment of oral candidiasis.. Mucoadhesive buccal tablets containing the drug nystatin are an alternative to oral suspensions, which cause low therapeutic adherence to the treatment of oral candidiasis. Purified cashew gum has been studied as a diluent and mucoadhesive agent in tablets.. Two batches of mucoadhesive tablets were produced, MT1 and MT 2, containing purified cashew gum, nystatin (500,000 IU), flavoring agent and with or without the presence of lubricant agent. The average weight, mechanical properties, dose uniformity, drug release profile, mucoadhesive properties and antimicrobial activity against. Tablets presented average weight of 329.1 ± 3.1 mg (MT1) and 334.6 ± 1.5 mg (MT2), hardness of 9.8 ± 0.8 KgF (MT1) and 8.3 ± 0.4 KgF (MT2), friability of 0.2% (MT1 and MT2), and dose uniformity of 102.20 ± 1.17% (MT1) and 99.06 ± 7.40% (MT2). MT1 and MT2 were able to swell, erode, release the drug and remain adhered to the pig's cheek up to 3 h for batch MT1 and 4 h for batch MT2, and the amount of nystatin released since the beginning of the test in both batches was sufficient to inhibit the growth of the fungus.. Therefore, the proposed formulation proved to be very promising and m

Topics: Anacardium; Candidiasis, Oral; Delayed-Action Preparations; Mouth Mucosa; Nystatin; Solubility; Tablets

This study was performed to develop a liquid crystalline system (LCS) incorporated with terpinen-4-ol and nystatin to evaluate its antifungal, antibiofilm, and synergistic/modulatory activity against Candida albicans. The LCS was composed of a dispersion containing 40% propoxylated and ethoxylated cetyl alcohol, 40% oleic acid, and 0.5% chitosan dispersion. According to analysis by polarized light microscopy, rheology, and mucoadhesion studies, the incorporation of 100% artificial saliva increased the pseudoplasticity, consistency index, viscosity, and mucoadhesion of the formulation. The minimum inhibitory concentration, minimum fungicidal concentration, and rate of biofilm development were used to evaluate antifungal activity; the LCS containing terpinen-4-ol and nystatin effectively inhibited C. albicans growth at a lower concentration, displaying a synergistic action. Therefore, LCS incorporated with terpinen-4-ol and nystatin is a promising alternative for preventing and treating infections and shows potential for the development of therapeutic strategies against candidiasis.

Topics: Antifungal Agents; Biofilms; Candida albicans; Candidiasis, Oral; Humans; Nystatin; Terpenes

Topics: Administration, Oral; Aged; Antifungal Agents; Candidiasis, Oral; Diagnosis, Differential; Drug Eruptions; Humans; Lung Neoplasms; Male; Nystatin; Suspensions

Antimicrobial photodynamic therapy (aPDT) has been considered an alternative therapeutic modality for the treatment of Candida infections. However, most studies are focused mainly on microorganism's inactivation efficiency. Here, we evaluated the efficacy of aPDT mediated by chloro-aluminum phthalocyanine encapsulated in cationic nanoemulsions (ClAlP-NE) to treat oral candidiasis in vivo and its effect on the adhesion and biofilm formation of Candida albicans.. For this, mice were immunosuppressed and inoculated with C. albicans to produce oral candidiasis. aPDT and Nystatin were applied for 5 successive sessions. Next, the microbiological evaluation was determined (CFU/ml) and the analyses of virulence factors (adhesion capacity and biofilm formation) were performed. Data were analyzed by Two-way ANOVA (α = 0.05).. aPDT was as effective as Nystatin reducing 1.4 and 2.0 log

Topics: Animals; Antifungal Agents; Biofilms; Candida albicans; Candidiasis, Oral; Emulsions; Indoles; Mice; Nanoparticles; Nystatin; Organometallic Compounds; Photochemotherapy; Photosensitizing Agents

To determine number, species of Candida and Candida resistance to antifungal therapy according to the metabolic control state and the associated salivary changes in patients with type 2 diabetes mellitus (DM2).. Samples of non-stimulated saliva were collected from 52 patients with DM2. Salivary pH was measured and cultured on Sabouraud glucose agar and the values of CFU/ml were calculated. The species were presumptively identified using CHROMagar Candida. Sixty six percent of the yeasts isolated were Candida albicans, followed by C. glabrata (20.7%). In patients with decompensated DM2, there was an inverse association between HbA1c value and salivary pH. At higher levels of salivary acidification, a greater diversity and quantity of yeasts of the genus Candida were observed. With nystatin, higher inhibition was observed at lower pH.. The antifungal therapies could be more effective if it consider, qualitative salivary characteristics as pH, that could determine the susceptibility of species of Candida to at least to nystatin, which is the most used antifungal for treatment to oral candidiasis in patients with DM2.

Topics: Adult; Antifungal Agents; Candida; Candida albicans; Candida glabrata; Candidiasis, Oral; Diabetes Mellitus, Type 2; Drug Resistance, Fungal; Female; Fluconazole; Humans; Microbial Sensitivity Tests; Nystatin

To evaluate the importance of Candida glabrata, Candida parapsilosis and their close-related species, Candida bracarensis, Candida nivariensis, Candida metapsilosis and Candida orthopsilosis in patients with oral candidiasis and, to determine the in vitro activities of antifungal drugs currently used for the treatment.. One hundred fourteen isolates of C. glabrata and 97 of C. parapsilosis, previously identified by conventional mycological methods, were analysed by molecular techniques. In vitro antifungal susceptibility to fluconazole, itraconazole, miconazole, and nystatin was evaluated by CLSI M44-A2 disk diffusion test, and by CLSI M27-A3 microdilution for fluconazole.. All C. glabrata isolates were identified as C. glabrata sensu stricto, 93 out of 97 C. parapsilosis isolates as C. parapsilosis sensu stricto, three as C. orthopsilosis and one as C. metapsilosis. Candida glabrata was mainly isolated in mixed cultures but C. parapsilosis complex was more frequent in pure culture. Candida metapsilosis and C. orthopsilosis were isolated as pure culture and both species were susceptible to all antifungal agents tested. Most C. glabrata isolates were susceptible to miconazole and nystatin, but resistant to fluconazole and itraconazole. Azole cross resistance was also observed. Candida parapsilosis isolates were susceptible to fluconazole although azole cross resistance to miconazole and itraconazole was observed.. This study highlights the importance of accurate identification and antifungal susceptibility testing of oral Candida isolates in order to have an in-depth understanding of the role of C. glabrata and C. parapsilosis in oral candidiasis.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Antifungal Agents; Candida glabrata; Candida parapsilosis; Candidiasis, Oral; Drug Resistance, Fungal; Female; Humans; Male; Miconazole; Middle Aged; Nystatin; Polymerase Chain Reaction; Polymorphism, Restriction Fragment Length; Prevalence

Topics: Administration, Oral; Antifungal Agents; Candida albicans; Candidiasis, Chronic Mucocutaneous; Candidiasis, Oral; Caspofungin; Child; Drug Resistance, Fungal; Drug Therapy, Combination; Female; Humans; Immunoglobulins, Intravenous; Mouthwashes; Mutation; Nystatin; Phagocytes; Treatment Outcome

Oral mucositis (OM) is a common adverse reaction to radiotherapy and chemotherapy in oncology. Its treatment requires oral formulations that enhance therapy compliance, improve administration and ensure drug effectiveness. Solid dosage forms that act by slow dissolution, such as pastilles, are an effective alternative to mouthwashes, for their versatility, ease of administration and extended residence time in the oral cavity. The present work describes the development and stability studies of an innovative formulation of nystatin and lidocaine pastilles for the treatment of oral mucositis. Full pharmaceutical quality testing was carried out, including disintegration and dissolution testing, texture profile analysis, grittiness and an antifungal activity testing. A soft pastille formulation containing 0.25% lidocaine and 78,000 IU nystatin was obtained, presenting suitable pharmaceutical characteristics, as a disintegration time of 17 ± 2 min, dissolution rate and microbiological and physicochemical for 30 days when stored at 2-8 °C under light protection. Palatability was also evaluated, being well accepted by a panel of 38 healthy volunteers. This formulation allows an accurate drug dosing by the prescriber, while enabling the patients to control the retention time of the drugs in the oral cavity and consequently manage their pain treatment.

Topics: Antifungal Agents; Candida albicans; Candidiasis, Oral; Drug Liberation; Hardness; Humans; Lidocaine; Nystatin; Stomatitis; Tablets

Treatment for oral candidiasis in warfarin users may be complicated by drug-drug interactions (DDIs) between warfarin and topically applied antimycotics. However, current knowledge of these putative DDIs is merely based on case series. We therefore performed a cohort cross-over study with the objective to evaluate the potential DDIs between warfarin and miconazole oral gel or nystatin oral solution. The cohort consisted of individuals using warfarin in the period of 1998-2012 (n ≈ 7400). We collected data on cohort members' measurements of the international normalized ratio (INR) from a clinical database, and obtained information on their use of topically applied miconazole and nystatin from a regional prescription register. Potential DDIs were assessed by comparing INR values before and after initiation of an antimycotic drug. Among 17 warfarin users exposed to miconazole oral gel, the mean INR increased from 2.5 (95% CI: 2.1-2.8) to 3.8 (95% CI: 2.8-4.8) after exposure, corresponding to a mean INR increase of 1.4 (95% CI: 0.3-2.4). Among 30 warfarin users exposed to nystatin oral solution, the mean INR was 2.7 (95% CI: 2.3-3.1) before and 2.5 (95% CI: 2.2-2.9) after exposure. In conclusion, we found evidence supporting a clinically relevant drug-drug interaction between warfarin and miconazole oral gel. In contrast, we did not find any indication of an interaction between warfarin and nystatin oral solution. Nystatin rather than miconazole should be preferred when treating warfarin users for oral candidiasis.

Topics: Administration, Oral; Aged; Antifungal Agents; Blood Coagulation; Candidiasis, Oral; Cohort Studies; Cross-Over Studies; Drug Interactions; Female; Gels; Humans; International Normalized Ratio; Male; Miconazole; Middle Aged; Nystatin; Solutions; Warfarin

Oral candidiasis is a mycosis on the mucous membranes of the mouth but not limited to the mouth. Nystatin is one of the most frequently employed antifungal agents to treat infections and may be safely given orally as well as applied topically but its absorption through mucocutaneous membranes such as the gut and the skin is minimal. The purpose of this study is to enhance the effectiveness of nystatin using particulate system such as beads, micro- and nanoparticles of alginate incorporated into toothpaste. Those particulate systems of nystatin were prepared by extrusion/external gelation for beads and emulsification/internal gelation for micro- and nanoparticles and characterized. Small, anionic charged and monodispersed particles were successfully produced. The type of particulate system influenced all previous parameters, being microparticles the most suitable particulate system of nystatin showing the slowest release, the highest inhibitory effect of Candida albicans over a period of one year. Those results allowed the conclusion that alginate exhibits properties that enable the in vitro functionality of encapsulated nystatin and thus may provide the basis for new successful approaches for the treatment of oral antifungal infections such as oral candidiasis.

Topics: Alginates; Antifungal Agents; Candida albicans; Candidiasis, Oral; Chemistry, Pharmaceutical; Glucuronic Acid; Hexuronic Acids; Microbial Sensitivity Tests; Mouth; Mucous Membrane; Nanoparticles; Nystatin; Toothpastes

Ability to produce hemolysin by Candida species is an important determinant of its pathogenicity. Candida dubliniensis is implicated in the causation of oral candidosis, which can be treated with polyene, echinocandin, and azole groups of antifungal agents as well as chlorhexidine. After oral application, however, the concentrations of these agents tend to decrease quickly to subtherapeutic levels due to the peculiarity of the oral environment. In this study, we have evaluated the effect of short-term exposure of sublethal concentrations of these drugs on hemolysin production by oral C. dubliniensis isolates obtained from two different geographical locale.. Twenty C. dubliniensis oral isolates obtained from Kuwait and Sri Lanka were exposed to sublethal concentrations of nystatin, amphotericin B, caspofungin, ketoconazole, fluconazole, and chlorhexidine for 1 h. Thereafter, the drugs were removed by dilution and the hemolysin production determined by a previously described plate assay.. Hemolysin production of these isolates was significantly suppressed with a percentage reduction of 17.09, 16.45, 17.09, 11.39, 8.23 and 12.03 following exposure to nystatin, amphotericin B, caspofungin, ketoconazole, fluconazole, and chlorhexidine, respectively.. Brief exposure to sublethal concentrations of drugs with antifungal properties appears to reduce the pathogenic potential of C. dubliniensis isolates by suppressing hemolysin production.

Topics: Amphotericin B; Antifungal Agents; Candida; Candidiasis, Oral; Caspofungin; Chlorhexidine; Echinocandins; Fluconazole; Hemolysin Proteins; Humans; Ketoconazole; Kuwait; Lipopeptides; Microbial Sensitivity Tests; Nystatin; Sri Lanka; Time Factors

Concomitant allergic reactions to multiple drugs are uncommon. We report the case of a 66-year-old woman who presented with concomitant sensitization to inhaled budesonide and oral nystatin presenting as allergic contact stomatitis and systemic allergic contact dermatitis. It is notable that one of the reactions was caused by oral nystatin, which generally is not considered to be allergenic due to its poor intestinal absorption. Diagnoses were confirmed on patch testing with histologic examination along with oral challenge testing. We also used challenge testing to rule out cross-reactivity among nystatin and other macrolide drugs, both antifungals and antibiotics.

Topics: Administration, Inhalation; Aged; Antifungal Agents; Budesonide; Candidiasis, Oral; Cough; Dermatitis, Allergic Contact; Female; Glucocorticoids; Humans; Nystatin; Stomatitis

The wide use of topical and systemic antifungal agents as the conventional treatment for oral candidiasis has caused Candida albicans to develop resistance to these agents. The aims of this study were to evaluate the effects of photodynamic therapy (PDT) and chitosan on buccal candidiasis and study the possible enhancive effect of chitosan on the photosensitizer methylene blue.. Thirty-five DBA/2 immunosuppressed mice were orally inoculated with a suspension of Candida albicans. The animals were randomized into seven groups (n = 5 per group): Group 1 (control); Group 2 (nystatin); Group 3 (PDT); Group 4 (chitosan 1.5 mg/ml); Group 5 (chitosan 3 mg/ml); Group 6 (PDT + chitosan 1.5 mg/ml); and Group 7 (PDT + chitosan 3 mg/ml). The Candida albicans count was evaluated on days 3, 5, 7, and 11 after inoculation. At last, macroscopic and microscopic analyses of the tongue dorsa were performed.. On day 7 after inoculation, the control group showed a greater number of Candida albicans (5.25 ± 0.41 log10 CFU/ml), with significant differences compared to all other groups (P ≤ 0.05). On day 11 after inoculation, animals treated with PDT showed lower CFU/ml count. Groups 2, 3, 4, 5, and 6 showed fewer microscopic candidiasis lesions than Groups 1 and 7.. PDT has an antifungal effect, even greater than nystatin. Chitosan has a powerful fungicide effect but did not possess any enhancive effect on methylene blue.

Topics: Animals; Antifungal Agents; Candida albicans; Candidiasis, Oral; Chitosan; Disease Models, Animal; Epithelium; Female; Methylene Blue; Mice; Mice, Inbred DBA; Mucous Membrane; Nystatin; Photochemotherapy; Photosensitizing Agents; Random Allocation

The overall goal of this research was to produce a stable hot-melt extruded 'Antifungal Denture Adhesive film' (ADA) system for the treatment of oral candidiasis.. The ADA systems with hydroxypropyl cellulose (HPC) and/or polyethylene oxide (PEO) containing clotrimazole (10%) or nystatin (10%) were extruded utilizing a lab scale twin-screw hot-melt extruder. Rolls of the antifungal-containing films were collected and subsequently die-cut into shapes adapted for a maxillary (upper) and mandibular (lower) denture.. Differential scanning calorimeter and powder X-ray diffraction results indicated that the crystallinity of both APIs was changed to amorphous phase after hot-melt extrusion. The ADA system, containing blends of HPC and PEO, enhanced the effectiveness of the antimicrobials a maximum of fivefold toward the inhibition of cell adherence of Candida albicans to mammalian cells/Vero cells. Remarkably, a combination of the two polymers without drug also demonstrated a 38% decrease in cell adhesion to the fungi due to the viscosity and the flexibility of the polymers. Drug-release profiles indicated that both drug concentrations were above the minimum inhibitory concentration (MIC) for C. albicans within 10 min and was maintained for over 10 h. In addition, based on the IC50 and MIC values, it was observed that the antifungal activities of both drugs were increased significantly in the ADA systems.. Based on these findings, the ADA system may be used for primary, prophylaxis or adjunct treatment of oral or pharyngeal candidiasis via controlled release of the antifungal agent from the polymer matrix.

Topics: Adhesives; Animals; Antifungal Agents; Calorimetry, Differential Scanning; Candidiasis, Oral; Cellulose; Chemistry, Pharmaceutical; Clotrimazole; Dentures; Microbial Sensitivity Tests; Nystatin; Polyethylene Glycols; X-Ray Diffraction

The aim of this study was to evaluate the attitude of Jordanian dentists towards the treatment of oral candidiasis and their current antifungal prescribing habits, shedding more light on the possible influence of their socio-professional factors on the pattern of prescribing and practice.. A structured validated questionnaire was developed and tested; it was then emailed to a random sample of 600 Jordanian dental practitioners during the period of this cross-sectional survey. The questionnaire recorded practitioners' personal details and their attitude and prescribing of antifungal therapy for oral candidiasis. Statistical significance was based on probability values of <0.05 and was measured using the chi-square and Fisher's exact tests. Multiple logistic regression analysis was used to analyse the influence of respondents' socio-professional factors on their attitude towards oral candidiasis.. Of the 423 questionnaires returned, only 330 were included. The attitude of respondents was significantly influenced by their experience [odds ratio (OR) = 0.14; P < 0.001] and workplace (OR = 4.70; P < 0.001). Nystatin was the most commonly prescribed antifungal agent (78.2%), followed by miconazole (62.4%), which was prescribed for topical use. Systemic antifungals were prescribed by 21.2% of respondents, with a significant (P < 0.05) association with the country in which their qualification was obtained.. The attitude towards the treatment of oral candidiasis is much better among the least-experienced dentists working in private practice. Nystatin and miconazole are the most popular choices of antifungal agents among Jordanian dentists.

Topics: Administration, Topical; Adult; Aged; Amphotericin B; Antifungal Agents; Attitude of Health Personnel; Candidiasis, Oral; Cross-Sectional Studies; Drug Prescriptions; Female; Fluconazole; Humans; Jordan; Male; Miconazole; Middle Aged; Nystatin; Practice Patterns, Dentists'; Private Practice; Professional Practice; Public Health Dentistry; Referral and Consultation; Sex Factors; Workplace

Limitations of antifungal agents used in the treatment of oral candidiasis, as the development of resistant strains, are known by the scientific community. In this context, the aim of this study was to evaluate the antifungal activity of thymol against Candida albicans, Candida tropicalis and Candida krusei strains and to determine its mode of action and synergistic effect when combined with the synthetic antifungal nystatin.. The minimum inhibitory concentration (MIC) was determined using a microdilution technique, and the minimum fungicidal concentration (MFC) was determined via subculture sowing. The mode of action of thymol was established by verifying fungal growth in the presence of sorbitol or ergosterol. The fractional inhibitory concentration index (FIC) was determined using the checkerboard method.. Thymol presented an antifungal effect, with MICs of 39 μg/mL for C. albicans and C. krusei and 78 μg/mL for C. tropicalis. The results of the antifungal test remained unchanged in the presence of sorbitol; however, the MIC value of thymol against C. albicans increased eight times (from 39.0 to 312.5 μg/mL) in presence of exogenous ergosterol. The combination of thymol and nystatin reduced the MIC values of both products by 87.4%, generating an FIC index of 0.25.. Thymol was found to have a fungicidal effect on Candida species and a synergistic effect when combined with nystatin.

Topics: Antifungal Agents; Candida; Candidiasis, Oral; Drug Synergism; Humans; Microbial Sensitivity Tests; Mouth; Nystatin; Thymol

To compare the efficacy of 2 strategies that use nystatin to prevent thrush and Candida esophagitis in kidney transplant recipients.. A retrospective chart review was conducted of adult kidney transplant recipients at our center, where the protocol for prophylaxis against fungal infection was changed in March 2013. Before the protocol change, kidney transplant recipients received nystatin for 1 month (before group) and after the change they received nystatin for the duration of admission (after group). The primary outcome measure was the incidence of thrush and Candida esophagitis within 3 months after transplant. Analyses were conducted on all kidney transplant recipients (intention to treat) and on only those kidney transplant recipients who received at least 1 dose of nystatin (modified intention to treat). Additional data collected included the duration of nystatin and immunosuppression regimens. The Student t test and Fisher exact test were used to calculate P values for continuous and categorical data.. A total of 84 kidney transplant recipients, 42 in each cohort, were included in the analysis. The groups did not differ significantly at baseline. Nystatin was administered for a mean of 29 days in the before group and 5.74 days in the after group. Overall, 3 kidney transplant recipients (4%), all from the after group, experienced an episode of thrush and no patients experienced Candida esophagitis. Two recipients who experienced thrush did not receive any nystatin.. Limiting the administration of nystatin to the duration of admission after transplant may be sufficient for prophylaxis of fungal infections in kidney transplant recipients.

Topics: Adult; Antifungal Agents; Candidiasis; Candidiasis, Oral; Cohort Studies; Female; Humans; Kidney Transplantation; Male; Middle Aged; Nystatin; Retrospective Studies; Time Factors; Transplant Recipients

The postantifungal effect (PAFE) has an impact on candidal pathogenicity. However, there is no information on either the PAFE or its impact on adhesion traits of oral Candida dubliniensis isolates. Oral candidosis can be treated topically with nystatin. Adhesion to buccal epithelial cells (BEC), germ tube (GT) formation and relative cell surface hydrophobicity (CSH) are all colonisation attributes of candidal pathogenicity. Hence, the main objective of this study was to investigate the in vitro PAFE on 20 C. dubliniensis isolates following exposure to nystatin. In addition, the impact of nystatin-induced PAFE on adhesion to BEC, GT formation and relative CSH of C. dubliniensis isolates were also evaluated. After determining the minimum inhibitory concentration (MIC) of nystatin, C. dubliniensis isolates were exposed to sublethal concentrations of nystatin for 1 h. Following this exposure, the drug was removed and PAFE, adhesion to BEC, GT formation and relative CSH were determined by a previously described turbidometric method, adhesion assay, germ tube induction assay and biphasic aqueous-hydrocarbon assay respectively. MIC (μg/ml) of C. dubliniensis isolates to nystatin ranged from 0.09 to 0.78. The nystatin-induced mean PAFE (hours) on C. dubliniensis isolates was 2.17. Compared with the controls, exposure to nystatin suppressed the ability of C. dubliniensis isolates to adhere BEC, GT formation and relative CSH by a mean percentage reduction of 74.45% (P < 0.0001), 95.92% (P < 0.0001) and 34.81 (P < 0.05) respectively. Hence, brief exposure of C. dubliniensis isolates to nystatin would continue to wield an antifungal effect by suppressing growth as well as its adhesion attributes.

Topics: Antifungal Agents; Candida; Candidiasis, Oral; Cell Adhesion; Epithelial Cells; Humans; Nystatin

To review 22 patients with globus pharyngis among a group of 39 patients who presented with burning mouth syndrome and to highlight the clinical presentation and treatment outcome of these oropharyngeal symptoms, often ignored by practicing oral surgeons.. We carried out a retrospective review of 39 patients with burning mouth syndrome seen at oral surgery units of three specialist hospitals in Enugu, Nigeria between 2001 and 2010. The focus was on the 22 of these patients with burning mouth syndrome and globus pharyngis (the persistent sensation of having phlegm, a pill or some other sort of obstruction in the throat when there is none). Relevant information included patients' oral habits and dental status, past medical history, sociodemographic data, onset of symptoms and treatment outcome.. Amongst the 22 patients, 8 (36.4%) were males while 14 (63.6%) were females, giving a male to female ratio of 1:1.8. Of the 8 male patients, 3 (37.5%) were retrenched workers, 2 (25%) were drug addicts, 2 (25%) had a history of psychiatric problems and 1 (12.5%) had post-radiation therapy due to diagnosis of adenocystic carcinoma. Amongst the 14 female patients, 6 (42.8%) were divorcees, 3 (21.4%) were unemployed and unmarried, 2 (14.3%) had menopausal problems, 2 (14.3%) had dental prostheses and 1 (7.2%) had a history of mental disorder.. Globus pharyngis can present at the same time in some individuals with burning mouth syndrome. The emotional aetiological factor in this unusual ailment calls for proper examinations and a multidisciplinary approach in the management of patients who presented with burning mouth syndrome, especially with a history of depression.

Topics: Adult; Aged; Analgesics, Opioid; Anti-Anxiety Agents; Antifungal Agents; Bromazepam; Burning Mouth Syndrome; Candidiasis, Oral; Conversion Disorder; Female; Follow-Up Studies; Humans; Male; Mental Disorders; Middle Aged; Nigeria; Nystatin; Opportunistic Infections; Pharyngeal Diseases; Retrospective Studies; Social Class; Tramadol; Unemployment; Young Adult

To evaluate the impact of brief and sequential exposure to nystatin on the germ tube formation and cell surface hydrophobicity of oral isolates of Candida albicans obtained from patients infected with human immunodeficiency virus (HIV).. After determining the minimum inhibitory concentration of nystatin, 10 oral isolates of C. albicans from 10 different HIV-infected patients were briefly (1 h) and sequentially (10 days) exposed to subtherapeutic concentrations of nystatin. Following a subsequent drug removal, the germ tube formation and cell surface hydrophobicity of these isolates were determined via a germ tube induction assay and an aqueous hydrocarbon assay, respectively. The data obtained from these assays for the control (unexposed to nystatin) and nystatin-exposed isolates were analyzed using Student's t tests.. The mean percentage reduction in the germ tube formation and cell surface hydrophobicity of the nystatin-exposed isolates compared to the controls was 30.12 ± 1.99 (p < 0.001) and 29.65 ± 2.33 (p < 0.001), respectively.. These data elucidate the possible pharmacodynamic mechanisms by which nystatin might operate in vivo in the modulation of candidal virulence.

Topics: Antifungal Agents; Candida albicans; Candidiasis, Oral; Cell Membrane; Dose-Response Relationship, Drug; HIV Infections; Humans; Hydrophobic and Hydrophilic Interactions; Microbial Sensitivity Tests; Nystatin

Secretion of hydrolytic enzymes such as hemolysin is considered an important virulence attribute of the opportunistic pathogenic fungus Candida. It is known that Candida spp. isolated from HIV-infected patients produce copious hemolysins. As common antifungal agents may perturb the production of extracellular enzymes, we evaluated the effect of three antifungals nystatin, amphotericin B and fluconazole on the hemolytic activity of Candida albicans and Candida tropicalis isolates from HIV-infected individuals. The impact of antimycotics on hemolytic activity was assessed by a previously described in vitro plate assay, after exposing ten isolates each of C. albicans and C. tropicalis recovered from HIV-infected individuals to sub-minimum inhibitory concentrations (sub-MIC) of nystatin, amphotericin B and fluconazole. All Candida isolates showed a significant reduction in hemolytic activity. The reduction was highest for amphotericin B-exposed C. albicans and C. tropicalis followed by nystatin and fluconazole. The effect of antimycotics was more pronounced on the hemolytic activity of C. tropicalis compared to that of C. albicans. Commonly used antifungal agents significantly suppress hemolysin activity of Candida species. This implies that the antifungals, in addition to their lethality, may modulate key virulence attributes of the yeast. The clinical relevance of this phenomenon in HIV disease and other similar pathologies remains to be determined.

Topics: Amphotericin B; Antifungal Agents; Candida albicans; Candida tropicalis; Candidiasis, Oral; Fluconazole; Hemolysin Proteins; HIV Infections; Humans; Microbiological Techniques; Nystatin; Virulence Factors

Candida species are opportunistic fungi, among which, Candida albicans is the most important species responsible for infections in immunocompromised patients with invasive fungal disease. Resistance of Candida species to antifungal drugs has led scientists to pay more attention to traditional medicine herbs. Due to the limitations in the treatment of fungal diseases such as shortages, high prices, antifungal side effects and drug resistance or reduced susceptibility to fungal drugs we decided to study the antifungal effects of herbal extracts of Syzygium aromaticum and Punica granatum.. Twenty-one isolates of oral C. albicans in patients with denture stomatitis referred to prosthesis department, Dental faculty of Tehran University of Medical Sciences were prepared and cultured. Plant extracts were prepared from the herbs market. Tests on patient samples and standard strains 5027ATCC (PTCC10231) yeast C. albicans were performed via well diffusion method. In addition, nystatin and methanol were used as positive and negative control, respectively. Finally, the antifungal effect of extracts using Statistical Repeated measurement ANOVA test was investigated.. Both S. aromaticum and P. granatum showed noticeable antifungal activity in well method. Syzygium aromaticum showed better anti candida activity than nystatin (P<0.001).. Due to increasing problems with fungal diseases, these findings suggest that the plant extracts of S. aromaticum and P. granatum showed good antifungal effects (P-value<0.001). S. aromaticum (inhibition zone diameter: 29.62) showed better antifungal effects than nystatin (inhibition zone diameter: 28.48).

Topics: Antifungal Agents; Candida albicans; Candidiasis, Oral; Drug Evaluation, Preclinical; Humans; Lythraceae; Microbial Sensitivity Tests; Nystatin; Plant Extracts; Syzygium

In comparison to the range of antibiotics used in medicine, the spectrum of antifungal and antiviral drugs used in primary dental care is relatively limited. In practical terms, there are only three antifungal agents and two antiviral agents that have a role. This paper will describe the clinical presentation of orofacial candidal and viral infections and the use of antimicrobial drugs in their management.

Topics: Acyclovir; Amphotericin B; Antifungal Agents; Antiviral Agents; Candidiasis, Oral; Cheilitis; Dental Care; Fluconazole; Glossitis; Guanine; Herpes Zoster; Humans; Miconazole; Mouth Diseases; Nystatin; Primary Health Care; Stomatitis, Herpetic

In this study, we developed a nanoparticulate nystatin formulation and performed a comparative evaluation against a commercial nystatin preparation of its in vitro and in vivo antifungal activities.. A nystatin nanosuspension was prepared from a commercially available suspension by wet-media milling. The nanosuspension was characterized for particle size by laser diffraction and assayed for content by HPLC. Its in vitro activity was evaluated against Candida albicans strains SC5314 and LAM-1 (12.5-5000 μg/mL) using an agar plate assay and its in vivo efficacy was evaluated using a murine model of oral candidiasis. Briefly, DBA/2 mice were immunosuppressed with cortisone acetate, orally infected with C. albicans strain LAM-1, and treated for 14 days with conventional nystatin suspension, nystatin nanosuspension or saline control. Efficacy endpoints were oral fungal burden, mouse survival and organ histopathology. A single-dose pharmacokinetic study was also performed.. The median particle size of the nystatin suspension was reduced from 6577 to 137 nm. The HPLC assay demonstrated a nystatin content of 98.7% ± 0.8% of the label claim. In vitro activity was superior to that of the conventional nystatin suspension at 100-5000 μg/mL concentrations. Beginning on day 3 of treatment, lower oral burdens of C. albicans were found in the nanosuspension group compared with the suspension and control groups. Mouse survival was also superior in the nanosuspension group. No systemic absorption was observed.. Taken together, these data reveal that nanonization of nystatin provides a novel approach to enhancing its efficacy in the treatment of oral candidiasis.

Topics: Animal Structures; Animals; Antifungal Agents; Candida albicans; Candidiasis, Oral; Colony Count, Microbial; Disease Models, Animal; Humans; Male; Mice; Mice, Inbred DBA; Microbial Sensitivity Tests; Mouth; Nanoparticles; Nystatin; Survival Analysis; Treatment Outcome

Yeasts occur as part of the normal human microbiota. Nevertheless, some species are opportunistic, affecting immunocompromised patients such as those undergoing oncologic treatment.. To detect the presence of yeasts in patients suffering from head and neck cancer who are receiving radiation therapy and display lesions in the oral cavity, compatible with candidiasis; and to evaluate the antifungal susceptibility of the isolates recovered.. Sixty samples from patients were obtained by swabbing the oral mucosa. Identification of isolates were performed by classical taxonomic, morphological and biochemical methods as well as by using commercial identification kits. Susceptibility to antifungal drugs was determined by the agar diffusion method with Neosensitabs(®) disks.. Forty-six samples (77%) yielded positive findings, and species recovered were: Candida albicans (22 isolates), Candida tropicalis (13 isolates), Candida parapsilosis (six strains), Candida krusei (three strains), Candida dubliniensis and Saccharomyces cerevisiae (one each). All strains were susceptible to itraconazole, clotrimazole, voriconazole, nystatin and amphotericin B. On the other hand, 65% of strains were miconazole-susceptible while 35%, showed intermediate susceptibility. With regard to ketoconazole, only three strains (7%) corresponding to C. albicans (one isolate) and C. krusei (two isolates) displayed intermediate susceptibility. Only C. krusei strains were resistant to fluconazole while all the other species were susceptible. Eventually, only six isolates (13%) were susceptible to terbinafine while the remaining strains were resistant in vitro.. Early detection of etiological agents causing lesions, as well as the evaluation of their susceptibility to commonly used drugs, are crucial in order to choose the appropriate treatment that will minimize complications while improving the quality of patients' lives.

Topics: Amphotericin B; Antifungal Agents; Candidiasis, Oral; Drug Resistance, Fungal; Head and Neck Neoplasms; Humans; Microbial Sensitivity Tests; Mycoses; Naphthalenes; Nystatin; Opportunistic Infections; Saccharomyces cerevisiae; Species Specificity; Terbinafine; Triazoles

Oral candidiasis is a significant problem in immune-compromised patients. The most common forms of mucosal candidiasis are oropharyngeal, oesophageal and vaginal, and more than 90% of HIV positive persons will manifest at least one episode of oropharyngeal candidiasis. Local and systemic factors such as uninterrupted daily use of a prosthesis by patients, smoking habit, as well as high glucose intake may contribute to the development of the lesion. The aim of this article is to report an uncommon case of oral candidiasis presenting an aggressive clinical behaviour in a 64-year-old male patient, with a significant smoking habit and a medical history of non-controlled diabetes. The lesion affected the hard and soft palate of the right side, revealing erythematous and ulcerated areas, elevated borders and central portions resembling necrosis, mimicking the clinical features of oral squamous cell carcinoma. However, the correct diagnosis of oral candidiasis was obtained after histopathological and cytological examinations and the patient was easily treated with traditional antifungal drugs and correction of his glucose levels.

Topics: Antifungal Agents; Candidiasis, Oral; Carcinoma, Squamous Cell; Diabetes Complications; Diagnosis, Differential; Humans; Male; Middle Aged; Nystatin; Palatal Neoplasms

Oropharyngeal candidiasis remains a significant clinical problem in HIV-infected and AIDS patients in regions of Africa where anti-retroviral therapy isn't readily available. In this study we identified the yeast populations associated with oral lesions in HIV-infected patients in Southwest Uganda who were receiving treatment with nystatin and topical clotrimazole. Samples were taken from 605 patients and 316 (52%) of these yielded yeast growth following incubation on Sabouraud dextrose agar. Samples were subsequently re-plated on CHROMagar Candida medium to facilitate identification of the yeast species present. The majority (56%) of culture-positive samples yielded a mix of two or more species. Candida albicans was present in 87% (274/316) of patient samples and accounted for 87% (120/138) of single species samples. Candida glabrata, Candida tropicalis and Candida norvegensis were also found in cultures that yielded a single species. No Candida dubliniensis isolates were identified in this population.

Topics: Adolescent; Adult; Aged; AIDS-Related Opportunistic Infections; Antifungal Agents; Candida; Candidiasis, Oral; Child; Clotrimazole; Culture Media; Female; HIV Infections; Humans; Male; Microbiological Techniques; Middle Aged; Mycology; Nystatin; Uganda; Young Adult

The aim of this study is to evaluate the oral colonization by Candida albicans in experimental murine immunosuppressed DBA/2 and treatment with probiotic bacteria. To achieve these objectives, 152 DBA/2-immunosuppressed mice were orally inoculated with a suspension of C. albicans containing 10(8) viable yeast cells, the animals were treated with nystatin or with the probiotics (Lactobacillus acidophilus and Lactobacillus rhamnosus). Evaluations were performed by Candida count from oral mucosa swabbing. The oral mucosa colonization by C. albicans started at day 1 after inoculation, remained maximal from day 3 until day 7, and then decreased significantly. Probiotics reduced the C. albicans colonization significantly on the oral mucosa in comparison with the untreated animal group. In the group treated with L. rhamnosus, the reduction in yeast colonization was significantly higher compared with that of the group receiving nystatin. Immunosuppressed animal model DBA/2 is a relevant model for experimental Candida oral colonization, and the treatment with probiotics in this model may be an effective alternative to prevent it.

Topics: Animals; Antifungal Agents; Candida; Candidiasis, Oral; Colony Count, Microbial; Cyclophosphamide; Disease Models, Animal; Immunosuppression Therapy; Immunosuppressive Agents; Lacticaseibacillus rhamnosus; Lactobacillus acidophilus; Male; Mice; Mice, Inbred DBA; Mouth Mucosa; Nystatin; Palate; Probiotics; Random Allocation; Tongue

Topics: Administration, Oral; Aged, 80 and over; Antifungal Agents; Candidiasis, Oral; Chronic Disease; Hiccup; Humans; Male; Nystatin; Treatment Outcome

Establishment of an effective prophylaxis against oral candidiasis by local treatment is essential for immunocompromised patients. The aim of the study is to assess effectiveness and stability of antifungal suspensions for mouthrinses. The assessed suspensions are compounded by one solvent among sterile water, spring water or sodium bicarbonate associated with amphotericin B (Fungizone®) or nystatine (Mycostatine®). Two others mixes are assessed: Mycostatine®-bicarbonate and Mycostatine®-Hextril®-bicarbonate as well as the two straight antifungal. In vitro activity is tested on five Candida species (C. albicans, C. glabrata, C. krusei, C. parapsilosis, C. tropicalis) after a five minutes contact between yeasts and the assessed suspension. A galenic study is realized during 3 days. Mixes associating a polyene with sodium bicarbonate have no effectiveness on Candida albicans, others mixes shows intermediate effectiveness (the percentage of yeast growth inhibition lies between 35% and 68%). Effectiveness results of Hextril®-based mixes are not explainable because of alcohol in its composition. Spring water-based mixes must be evicted due to microbiologic contaminations after 48hours. Mycostatine®-Hextril®-bicarbonate mix is not stable during 3 days. All those mouthrinses, poorly effective, excepted on C. glabrata, should be avoided. Straight Mycostatine® shows a good antifungal effectiveness excepted on C. krusei and its use should be recommended.

Topics: Amphotericin B; Antifungal Agents; Candida; Candida albicans; Candida glabrata; Candidiasis, Oral; Drug Stability; Hexetidine; Humans; Mouthwashes; Nystatin; Sodium Bicarbonate; Suspensions

Oral candidosis is a common opportunistic infection in patients suffering from mucositis (after chemotherapy and radiotherapy administration) and must be treated to prevent infecting other tissue. Nystatin (Nys) is one of the most prescribed drugs to treat this pathology, but because of its physicochemical properties, its pharmaceutical-technological requirements make it a challenge. The purpose of this work was the development and characterization of an optimal Nys delivery system for the potential treatment of oral candidosis avoiding undesirable side effects and toxicity of potential systemic absorption. A nanoemulsion was developed, evaluated, and characterized. It has been formulated successfully as a stable nanoemulsion with a droplet size of 138 nm. Release parameters were estimated using different mathematical approaches, and from the results of ex vivo permeation study of Nys through porcine buccal mucosa, it could be hypothesized that no systemic effects would happen. Microbiologic studies performed revealed an enhanced antifungal effect of the Nys-loaded nanoemulsion. Also, the evaluation of the treated buccal mucosa ultrastructure by transmission electron microscopy revealed a harmless effect. Thus, it could be inferred that the developed formulation could be potentially utilized for candidosis infection under mucositis conditions.

Topics: Absorption; Antifungal Agents; Candida albicans; Candidiasis, Oral; Cheek; Chemistry, Pharmaceutical; Drug Delivery Systems; Emulsions; Mouth Mucosa; Nanoparticles; Nystatin; Particle Size; Saccharomyces cerevisiae

Topics: Administration, Inhalation; Aged; Amphotericin B; Anti-Asthmatic Agents; Asthma; Candidemia; Candidiasis, Oral; Drug Therapy, Combination; Endophthalmitis; Eye Infections, Fungal; Female; Fluconazole; Glucocorticoids; Humans; Nystatin; Risk Factors

Topics: Antifungal Agents; Candidiasis, Oral; CD4 Lymphocyte Count; Clotrimazole; Deglutition Disorders; HIV Infections; Humans; Immunocompromised Host; Male; Nystatin; Young Adult

Candida albicans is an opportunistic agent that colonizes the oral mucosa.. To determine the attitude of Spanish dentists toward the oral treatment of candidiasis.. Between May and November 2006, a questionnaire was circulated to a random selection of 1134 dentists obtained from the General Dental Council's main list. The survey consisted of a block of socio-demographic items followed by another block related to the diagnosis and treatment of oral candidiasis. Replies to the questionnaire were received from 840 (74%) dentists.. 50.4% of respondents were men, and 48.1% were female with a mean age of 38 and 12.2 years of professional experience. Miconazole was the most popular choice of antifungal agent prescribed (59.3%), followed by nystatin (57.7%) for topical use. Systemic antifungal agents were used by 30.20% of dentists, with a strong association between their use and the number of years in practice, gender and professional qualifications (P < 0.005).. Most Spanish dentists make clinical diagnosis and treat oral infections by C. albicans themselves with topical drugs (miconazole and nystatin) as a first choice. Systemic treatments are more commonly chosen by male dentists with long professional experience, especially by stomatologists.

Topics: Administration, Topical; Adult; Antifungal Agents; Attitude of Health Personnel; Candidiasis, Oral; Clotrimazole; Dentists; Female; General Practice, Dental; Humans; Ketoconazole; Male; Miconazole; Nystatin; Oral Medicine; Private Practice; Professional Practice; Public Health Dentistry; Sex Factors; Spain; Stomatitis, Denture; Surveys and Questionnaires; Time Factors

Mucoadhesive tablets containing nystatin (10 mg) were evaluated in vivo. The assays were carried out with 12 healthy volunteers and the concentration of nystatin in saliva was determined at different times. Tablets remained attached to the buccal mucosa during 270 min +/- 30 min. No evidence of ulceration or bleeding was observed. Typical appearance of intact human buccal mucosa was seen before and after contact with the tablet. The tablets were well accepted by the volunteers, although most of the volunteers reported a light bitter taste, probably due to nystatin. Concentration of nystatin in saliva was several times higher than MIC over a period of approximately 4.5 h, which was in agreement with the behavior observed in vitro. These results allow us to infer that the administration of these mucoadhesive tablets could be advantageous compared to conventional formulations and mucoadhesive extended-release tablets might produce better therapeutic performance than conventional formulations in the treatment of oral candidosis.

Topics: Adhesives; Adult; Algorithms; Antifungal Agents; Biopharmaceutics; Candidiasis, Oral; Chromatography, High Pressure Liquid; Delayed-Action Preparations; Female; Hardness; Humans; Male; Mouth Mucosa; Nystatin; Saliva; Solubility; Solutions; Tablets; Young Adult

Although in vitro studies on the release of antifungal agents from tissue conditioners have been done, no in vivo research on the topic could be found. The purpose of this study was to determine the in vivo effect of an antifungal agent released from a tissue conditioner on the salivary yeast count. Forty edentulous patients with denture stomatitis caused by Candida albicans were divided in two groups. Group 1 (control) was treated with a tissue conditioner only. Group 2 was treated with a tissue conditioner incorporating 500,000 U nystatin. Oral rinses were performed by both groups before treatment and every second day during treatment for a period of 14 days. Total yeast counts of the oral rinses were performed and the averages and standard deviations for both groups calculated and logarithm-transformed data of the counts over time were statistically analysed using the Wilcoxon signed-rank test. The average oral rinse yeast count of the control group decreased up to day 4. Thereafter, the count increased till the end of the test period. At day 14, the oral rinse yeast level was higher than the pre-treatment level. The average yeast count of the test group decreased up to day 7. Thereafter, the count increased but remained significantly lower (P=0.01) than the control group and did not return to its pre-treatment level. A nystatin-containing short-term denture liner significantly decreases the salivary yeast count of patients with denture stomatitis compared with a liner without nystatin.

Topics: Adult; Aged; Antifungal Agents; Candidiasis, Oral; Denture Liners; Female; Humans; Male; Middle Aged; Nystatin; Pilot Projects; Saliva; Stomatitis, Denture; Tissue Conditioning, Dental

Although Nystatin has been used since 1950s as a non-absorbable antifungal agent, there is still no reliable in-vivo data available stating a dose-effect relationship of Nystatin-suspension in the treatment of oropharyngeal infection with Candida albicans. Here, we studied the efficacy of a commercially available topical Nystatin suspension in a new ex-vivo model of candidiasis using porcine oral mucosa. After 48 and 96 h of C. albicans infection, 230 IU Nystatin (standard dosage), 100 IU and 20 IU proved to be equally efficacious. Multiple applications of Nystatin were not superior compared with single application. In dosages of 10 and 0.1 IU the activity of Nystatin suspension against C. albicans was no longer confirmed. In an agar diffusion model, the minimal biocidal concentration of Nystatin proved to be 0.25 IU. Our results suggest that the proposed porcine ex-vivo model is much closer to the in-vivo situation compared with other established in-vitro models of the treatment of muco-cutaneous candidiasis and may provide a substitute for animal models in the investigation of antifungal agents. Additionally, it seems to be a valuable tool for further investigations of the pathogenesis of C. albicans infections.

Topics: Administration, Topical; Animals; Antifungal Agents; Candida albicans; Candidiasis, Oral; Microbial Sensitivity Tests; Mouth Mucosa; Nystatin; Organ Culture Techniques; Swine

To understand whether there were any differences of sensitivity to antifungals between the species of Saccharomyces (Candidas) isolated from oral cavity in the patients with oral candidosis and healthy volunteers. Observing the effect of nystatin topically used and discussing preliminarily the relationship between MIC and clinical effect in order to offer reference for clinical treatment.. The experiment was carried on 61 patients with candidosis in experimental group and 43 healthy volunteers in control group and isolates of Saccharomyces were obtained by the oral rinse technical method. To isolate and identify Saccharomyces in oral cavity by CHROMagar Saccharomyces culture medium and test the MIC of several antifungal agents such as nystatin, ketoconazole and fluconazole against Saccharomyces by NCCLSM27-A microdilution assay. 31 patients in experimental group were administered with nystatin, observing the clinical effect a week later and comparing the results with the MIC.. (1) The incidence of Saccharomyces was 78.69% and 30.23% in experimental group and control group respectively. The proportion of Saccharomyces albicans was 80.70% (experimental group) and 92.31% (control group). (2) There was no significant difference between the susceptibility of Saccharomyces albicans to fluconazole and ketoconazole (P > 0.05), but the MIC data of azole antifungals were lower than nystatin. (3) The susceptibility of Saccharomyces albicans to fluconazole, ketoconazole and nystatin was 95.65%, 80.43%, and 89.13%, and a few isolates were resistent to antifungal agents. (4) The effectiveness of nystatin was 87.10%, and there were a few cases which MIC differs from the clinical effect.. At present, the resistance of Saccharomyces in patients with oral fungal infection is not significant, most Saccharomyces albicans are sensitive to fluconazole, ketoconazole and nystatin. The MIC of fluconazole and ketoconazole are lower than nystatin, implying when the clinical effect of nystain is poor, to use an azole antifungal is optional. The MIC is relative to therapeutic effect to some degree, but it is not consistent completely.

Topics: Antifungal Agents; Candida albicans; Candidiasis, Oral; Fluconazole; Humans; Ketoconazole; Nystatin; Saccharomyces

Topics: Administration, Oral; Aged; Antifungal Agents; Candidiasis, Oral; Drug Eruptions; Female; Humans; Hypersensitivity, Delayed; Nystatin; Skin Tests

Chronic mucocutaneous candidiasis (CMC) is a rare disorder characterized by persistent or recurrent candidal infections of the skin, nails and mucous membranes or by a variable combination of endocrine failure as well as immunodeficiency. Oral clinicopathological features of CMC have seldom been described in detail.. Seven patients with CMC were reported in the study. The clinical and histological findings, etiological Candida species, immunological evaluation, and therapeutic pattern of oral lesions, were analyzed.. Long-standing whitish hyperplastic and nodule-like lesions with exaggerated deep fissure were the typical and characteristic oral manifestations presented by all patients. The tongue was the most common site affected. Histologically, no obvious distinction was found between CMC and other forms of candidal infection. Abnormal proportions of T-lymphocyte subsets and positive titers of autoantibody were observed in three subjects (42.9%) and one patient (14.3%) respectively. Meanwhile, four subjects (57.1%) showed decreased albumin and increased globulin, three cases (42.9%) had high levels of ESR. But no iron deficiency was found. Candida albicans was the microorganism isolated from these patients.. Multiple and widespread candidal infectious lesions can be observed on the oral cavity of CMC patients. Hyperplastic and nodule-like lesion with irremovable whitish patches and deep fissure are the most common oral manifestations of these patients. Dentists, otolaryngologists and pediatricians should be familiar with the clinical appearances of CMC to make an accurate diagnosis. Potential systemic disorders should be concerned to avoid the reoccurrence of oral candidiasis.

Topics: Adult; Antifungal Agents; Candida albicans; Candidiasis, Chronic Mucocutaneous; Candidiasis, Oral; Child; Female; Fluconazole; Humans; Male; Middle Aged; Mouth Mucosa; Nystatin

Trimethoprim-sulfamethoxazole (TMP-SMX) is a combination chemotherapeutic agent, a commonly used antibiotic. Adverse drug reactions occur in 6-8% of patients. Although, the most common adverse reactions include mild gastrointestinal distress and cutaneous events, also a wide range of hematological abnormalities have been ascribed to TMP-SMX. We report a 40-year-old male patient who developed an early onset neutropenia, thrombocytopenia, generalised rash and oral candidiasis after 5 days long TMP-SMX therapy. Although generalised rash may seen more and improves with discontinuation of the therapy; severe neutropenia, thrombocytopenia and oral candidiasis are seen very rare and rarely leads to fatality as it was in our case. Despite thrombocyte transfusions, whole blood transfusions, red cell concentrates and filgrastim therapy we lost our patient. We want to underline that although the TMP-SMX combination is usually well tolerated it can also lead to fatal complications.

Topics: Adult; Anti-Infective Agents; Anti-Inflammatory Agents; Candidiasis, Oral; Cefepime; Cephalosporins; Chlorhexidine; Drug Eruptions; Escherichia coli; Escherichia coli Infections; Exanthema; Fatal Outcome; Filgrastim; Granulocyte Colony-Stimulating Factor; Humans; Male; Meropenem; Neutropenia; Nystatin; Platelet Transfusion; Prednisolone; Recombinant Proteins; Thienamycins; Thrombocytopenia; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Anti-Infective Agents, Local; Antifungal Agents; Candida albicans; Candidiasis, Oral; Chlorhexidine; Drug Antagonism; Humans; Nystatin; Stomatitis, Denture

Amphotericin B and nystatin are two polyene antibiotics that are potent antifungal agents. These drugs are active against most pathogenic fungi like Aspergillus and Candida. Mouthrinses containing these drugs are used for preventive and curative treatment of fungal infections like oral candidiasis, which can cause multiple diseases in cancer patients. Because there were no marketed antifungal mouthrinses available, their preparations were performed at the hospital and town pharmacies. To date, there are no data available on the stability of both these drugs in the form of mouthrinses. Therefore, each mouthrinse had to be prepared extemporaneously. The aim of this study was to investigate the stability of amphotericin B (Fungizone) and nystatin (Mycostatine) in the form of mouthrinses containing 1.4% sodium hydrogen carbonate. The stability of these solutions was tested at different temperatures (4-37 degrees C) with or without electric- or sunlight exposure and in two types of containers (glass and polypropylene) over a 15-day period. The admixtures were also monitored for colour change and pH. Amphotericin B and nystatin were quantified by high-performance liquid chromatography. At 4 degrees C, amphotericin B and nystatin were stable for 15 days in polypropylene. When stored in polypropylene at room temperature, with or without light protection, amphotericin B and nystatin were stable for 3 and 4 days, respectively.

Topics: Amphotericin B; Antifungal Agents; Candidiasis, Oral; Chromatography, High Pressure Liquid; Drug Stability; Hydrogen-Ion Concentration; Mouthwashes; Nystatin; Sodium Bicarbonate; Temperature

Topics: Administration, Oral; Antifungal Agents; Candidiasis, Oral; Humans; Medical History Taking; Nursing Assessment; Nystatin; Oral Hygiene; Patient Education as Topic; Physical Examination; Risk Factors

The mechanism of the anticandidal action of the major phenolic components of oregano and clove essential oils - carvacrol and eugenol - was studied. This activity was also evaluated for the therapeutic efficacy in the treatment of the experimental oral candidiasis induced by Candida albicans in immunosuppressed rats.. In vitro, the addition of carvacrol at 0.1% or eugenol at 0.2% during the exponential growth of C. albicans was evaluated. The release of substances absorbing at 280 nm by cells treated with these two components was also measured spectrophotometrically. In vivo, oral candidiasis in immunosuppressed rats was established by inoculating 3 x 10(8) cells of C. albicans with a cotton swab on three alternate days. The number of colony counts was evaluated from the oral cavity of rats treated for eight consecutive days with carvacrol, eugenol or nystatin and compared to untreated controls.. Carvacrol and eugenol were fungicidal in exponentially growing C. albicans. Interestingly, this fungicidal effect was accompanied by the release of substances absorbing at 280 nm. In an immunosuppressed rat model of oral candidiasis, carvacrol or eugenol treatment significantly (P < 0.05) reduced the number of colony counts sampled from the oral cavity of rats treated for eight consecutive days compared to untreated control rats. Similar results were obtained with nystatin used as a reference treatment.. The in vitro results indicated that both carvacrol and eugenol exerted an anticandidal effect by a mechanism implicating an important envelope damage. Their in vivo efficacy on experimental oral candidiasis leads us to consider them as possible antifungal agents.

Topics: Analysis of Variance; Animals; Antifungal Agents; Candida albicans; Candidiasis, Oral; Colony Count, Microbial; Cymenes; Eugenol; Female; Humans; Male; Monoterpenes; Nystatin; Rats

Human immunodeficiency virus-associated nephropathy (HIVAN) has become the third leading cause of end-stage renal disease (ESRD) in African Americans, and is expected to grow exponentially. Highly active antiretroviral therapy (HAART) has significantly prolonged the survival of patients with HIV infection. Despite the growing number of HIV-positive dialysis patients with prolonged life expectancy, kidney transplantation with immunosuppression has been declined because it is considered a waste of scarce donor kidneys due to potential increases in morbidity and mortality.. The institutional review board of Drexel University College of Medicine and Hahnemann University Hospital approved this prospective study. The aim was to find out safety and success of kidney transplantation, and the effect of immunosuppression on HIV infection. Forty HIV-positive dialysis patients received kidney transplantation between February 2001 and January 2004. Patient inclusion criteria were maintenance of HAART, plasma HIV-1 RNA of <400 copies/mL, absolute CD4 counts of 200 cells/muL or more. Immunosuppression was basiliximab induction and maintenance with cyclosporine, sirolimus, and steroids. HAART was continued post-transplant. Acute rejections were diagnosed by biopsy and treated with methylprednisolone. Surveillance biopsies were completed at 1, 6, 12, and 24 months, and evaluated for subclinical acute rejection, chronic allograft nephropathy, and HIVAN.. One- and 2-year actuarial patient survival was 85% and 82%, respectively, and graft survival was 75% and 71%, respectively. Plasma HIV-1 RNA remained undetectable, and CD4 counts remained in excess of 400 cells per muL with no evidence of AIDS for up to 2 years.. One- and 2-year graft survival is comparable to other high-risk populations receiving kidney transplantation. One- and 2-year patient survival is higher than HIV patients maintained on dialysis. Immunosuppression does not adversely affect HIV recipients maintained on HAART in the short term.

Topics: AIDS-Associated Nephropathy; Candidiasis, Oral; Dapsone; Female; Graft Rejection; HIV Seropositivity; Humans; Kidney Failure, Chronic; Kidney Transplantation; Male; Middle Aged; Nystatin; Pneumocystis Infections; Retrospective Studies; Safety; Sarcoma Virus, Woolly Monkey; Survival Analysis; Treatment Outcome

The in vitro susceptibility of 618 Candida isolates to fluconazole, itraconazole, voriconazole, ketoconazole, miconazole, amphotericin B, and nystatin was determined. The isolates were obtained from 559 patients who had attended the UK dental hospital departments in Cardiff, Belfast, Glasgow or London. Antifungal susceptibility was assessed using a broth microdilution method following the National Committee for Clinical Laboratory Standards (NCCLS) M27-A guidelines. The majority of the test strains were C. albicans (n = 521) with few of these being resistant to fluconazole (0.3%). A low incidence of fluconazole resistance (0-6.8%) was similarly evident with all non albicans species (Candida glabrata, 5 of 59 resistant; Candida krusei, 0 of 7 resistant; Candida tropicalis, 0 of 13 resistant; Candida parapsilosis, 0 of 12 resistant; other Candida species, 0 of 6 resistant). Voriconazole, ketoconazole, and miconazole also revealed high activity against both C. albicans and non albicans isolates, and 23.7% of C. glabrata isolates were found to be resistant to itraconazole. There was little difference in the antifungal susceptibilities of Candida isolated from patients who had a history of previous antifungal therapy compared with those who had not received antifungal treatment. In summary, this surveillance study of antifungal susceptibility of oral candidal isolates in the UK, through the collaboration of four dental hospitals, demonstrates that oral Candida species have a high level of susceptibilities to a range of antifungal agents.

Topics: Amphotericin B; Antifungal Agents; Candida; Candida albicans; Candida glabrata; Candida tropicalis; Candidiasis, Oral; Drug Resistance, Fungal; Fluconazole; Humans; Itraconazole; Ketoconazole; Miconazole; Mouth Diseases; Nystatin; Pyrimidines; Triazoles; Voriconazole

To examine the current practice of antifungal prescribing by GDPs in the United Kingdom. Design A postal questionnaire circulated to a random selection of 400 dentists.. The questionnaires were analysed and the responses expressed as absolute and relative frequencies.. Responses to the questionnaire were received from 297 (74.3%) GDPs. Nystatin was the most popular choice of antifungal agent that GDPs would use, followed by miconazole, amphotericin B and fluconazole. The likelihood of use of miconazole was positively linked to recent date of graduation. Lack of knowledge regarding contraindications and problems with azole antibiotics was found in a significant minority of practitioners (36%).. The present study indicates that azole antifungal agents (especially miconazole) are becoming more widely used by GDPs, but that knowledge regarding potential problems with their use is sub-optimal. Nystatin remains the most popular choice of antifungal agent.

Topics: Age Factors; Amphotericin B; Antifungal Agents; Candidiasis, Oral; Drug Prescriptions; Fluconazole; General Practice, Dental; Humans; Miconazole; Nystatin; Practice Patterns, Dentists'; Surveys and Questionnaires; United Kingdom

Despite aggressive antifungal prophylaxis, the increased risk for systemic fungal infection in recipients of hematopoietic cell transplants (HCT) continues to be a significant concern because Candida infection can cause morbidity and mortality in these patients. The objectives of this study were to examine the relationship of oral colonization by Candida species to systemic infection, mortality, and the impact of antifungal treatment on a population of recipients of HCT.. One hundred and fifteen consecutive patients undergoing hematopoietic cell transplantation were evaluated. Oral examinations and cultures for Candida were completed before transplantation and on a weekly basis until discharge. The oral complications were assessed, and the level of mucositis was scored by using the National Cancer Institute grade. Systemic antifungal prophylaxis was provided to all patients. Chlorhexidine oral rinses were also routinely provided.. Colonization by Candida species was identified in 31% of patients. Fifty-six percent of patients with colonization had clinical evidence of oral candidiasis. Significantly decreased Candida colonization was seen in patients using chlorhexidine alone compared with those using chlorhexidine and nystatin together (P <.046). Twenty-five patients died in the immediate posttransplantation period, 17 of whom were Candida-positive. The length of hospital stay ranged from 15 to 153 days; increased stay was also associated with Candida colonization (P =.04). Seventy-four percent of all patients developed ulcerative mucositis. More severe mucositis was seen in patients undergoing chemotherapy and radiation therapy. There was no significant difference between Candida colonization and the presence or severity of mucositis.. Despite systemic and topical antifungal prophylaxis, oropharyngeal colonization by Candida species was common in patients who had received HCT. Candidiasis was commonly present in those who did not survive the early transplant period. Of the 25 patients who died early after the transplantation, 92% had ulcerative mucositis in comparison with 70% of those who survived, reflecting the association of oral mucositis with the toxicity of HCT. There was a significant relationship among allogeneic and autologous HCT, length of stay, and colonization of Candida. In patients undergoing systemic antifungal prophylaxis, chlorhexidine rinse was statistically more effective in reducing colonization by Candida than chlorhexidine and nystatin combined (P =.046).

Topics: Adult; Anti-Infective Agents, Local; Antifungal Agents; Candida albicans; Candidiasis, Oral; Cause of Death; Chemoprevention; Chlorhexidine; Female; Gingivitis, Necrotizing Ulcerative; Hematopoietic Stem Cell Transplantation; Humans; Length of Stay; Male; Middle Aged; Mouth; Mouthwashes; Nystatin; Stomatitis; Transplantation, Autologous; Transplantation, Homologous; Treatment Outcome

To evaluate the antifungal effect of a nystatin mouth rinse to control oral candidiasis of elderly patients in palliative care.. 52 cancer patients (mean age: 83 years) hospitalized in a long term care facility for chronically ill geriatric patients. Mouth rinsing with 15 ml nystatin solution (4,000 Ul/ml) was carried out for one minute, six times daily, over two weeks. Yeasts were collected and seeded on CHROMagar. Growth was read qualitatively and quantitatively after two days' incubation at 37 degrees C.. Clinical signs of oral candidiasis were observed in 31% of cases. High yeast scores were observed in 58% of the residents. There was an association between signs of oral candidiasis and high yeast scores (p < 0.001). Treatment for two weeks caused no clinical changes nor reduced yeast scores.. No clinical or antifungal effect from the nystatin suspension suggests that the concentration of nystatin in the mouth rinse was too low. A more effective procedure should be employed for antifungal treatment of terminally ill patients. Appropriate antimicrobial solutions with lubricating activity should be developed and applied to prevent oral diseases.

Topics: Aged; Aged, 80 and over; Antifungal Agents; Candidiasis, Oral; Chi-Square Distribution; Colony Count, Microbial; Female; Humans; Male; Mouthwashes; Neoplasms; Nystatin; Terminally Ill; Treatment Outcome

Though oral candidosis is an opportunistic fungal infection that commonly affects immunocompromised patients, little is known of its occurrence as a complication of Non-Hodgkin's lymphoma. This paper reports a case of oral candidosis in a 20-year-old Indonesian woman with this lymphoproliferative disease. She presented with acute pseudomembranous candidosis on the dorsum and lateral borders of the tongue, bilateral angular cheilitis and cheilocandidosis. The latter is a rare clinical variant of oral candidosis, and the lesions affecting the vermilion borders presented as an admixture of superficial erosions, ulcers and white plaques. Clinical findings were confirmed with oral smears and swabs that demonstrated the presence of hyphae, pseudohyphae and blastospores, and colonies identified as Candida albicans. A culture from a saline rinse was also positive for multiple candidal colonies. Lip and oral lesions were managed with Nystatin. The lesions regressed with subsequent crusting on the lips, and overall reduction in oral thrush. As Non-Hodgkin's lymphoma is a neoplastic disease that produces a chronic immunosuppressive state, management of its oral complications, including those due to oral candidosis, is considered a long-term indication.

Topics: Adult; Antifungal Agents; Candidiasis, Oral; Female; Humans; Immunocompromised Host; Lymphoma, Non-Hodgkin; Nystatin

Topics: Antifungal Agents; Breast Diseases; Candida albicans; Candidiasis; Candidiasis, Oral; Female; Fluconazole; Humans; Infant; Infant, Newborn; Lactation; Male; Nipples; Nystatin; Pain; Weaning

Topics: Aged; Anti-Ulcer Agents; Antifungal Agents; Candida albicans; Candidiasis, Oral; Female; Fluconazole; Gastroesophageal Reflux; Humans; Nystatin; Omeprazole; Treatment Failure

The objective of this work was to design a mucoadhesive tablet with a potential use in the treatment of oral candidosis. A 2-layered tablet containing nystatin was formulated. Lactose CD (direct compression), carbomer (CB), and hydroxypropylmethylcellulose (HPMC) were used as excipients. Tablets were obtained through direct compression. Properties such as in vitro mucoadhesion, water uptake, front movements, and drug release were evaluated. The immediate release layer was made of lactose CD (100 mg) and nystatin (30 mg). The CB:HPMC 9:1 mixture showed the best mucoadhesion properties and was selected as excipient for the mucoadhesive polymeric layer (200 mg). The incorporation of nystatin (33.3 mg) in this layer affected the water uptake, which, in turn, modified the erosion front behavior. Nystatin showed a first-order release. The polymeric layer presented an anomalous kinetic (n = 0.82) when this layer was individually evaluated. The mucoadhesive tablet formulated in this work releases nystatin quickly from the lactose layer and then in a sustained way, during approximately 6 hours, from the polymeric layer. The mixture CB:HPMC 9:1 showed good in vitro mucoadhesion. A swelling-diffusion process modulates the release of nystatin from this layer. A non-Fickian (anomalous) kinetic was observed.

Topics: Acrylic Resins; Adhesiveness; Administration, Oral; Antifungal Agents; Candidiasis, Oral; Chemistry, Pharmaceutical; Delayed-Action Preparations; Diffusion; Drug Compounding; Drug Design; Drug Evaluation, Preclinical; Hypromellose Derivatives; Lactose; Methylcellulose; Nystatin; Solubility; Tablets; Time Factors; Water

The present study assessed the susceptibility of Candida albicans strains, collected from HIV-positive patients with oral candidiasis, to a commercial 20% ethanol propolis extract (EPE) and compare it to the inhibitory action of the standardized antifungal agents nystatin (NYS), clotrimazole (CL), econazole (EC), and fluconazole (FL). Twelve C. albicans strains collected from HIV-positive patients with oral candidiasis were tested. The inhibition zones were measured with a pachimeter and the results are reported as means and standard deviation (M +/- SD). Data were analyzed statistically by the non-parametric Kruskal-Wallis test. EPE inhibited all the C. albicans strained tested. No significant difference was observed between the results obtained with NYS and EPE, while significant differences were observed between EPE and other antifungals. The C. albicans strains tested showed resistance to the remaining antifungal agents. The propolis extract used in this study inhibited the in vitro growth of C. albicans collected from HIV-seropositive Brazilian patients, creating/forming inhibition zones like those ones formed by NYS. This fact suggests that commercial EPE could be an alternative medicine in the treatment of candidiasis from HIV-positive patients. However, in vivo studies of the effect of EPE are needed to determine its possible effects on the oral mucosa.

Topics: AIDS-Related Opportunistic Infections; Anti-Infective Agents; Antifungal Agents; Brazil; Candida albicans; Candidiasis, Oral; Clotrimazole; Complementary Therapies; Drug Resistance, Fungal; Econazole; Ethanol; Fluconazole; HIV Seronegativity; HIV Seropositivity; Humans; Nystatin; Propolis; Solvents; Statistics, Nonparametric

The pattern of candidal colonisation was studied in a group of terminally ill patients receiving antifungal treatment for oral candidosis. A total of 43 isolates of C. albicans was collected pre- and post-antifungal treatment from patients up to a maximum period of 4 weeks. Isolates were analysed by electrophoretic karyotyping (EK) and by inter-repeat polymerase chain reaction (IR-PCR). Fifteen electrophoretic karyotypes and 17 IR-PCR profiles were identified. Sequential isolates from 10 patients yielded identical profiles in both EKs and IR-PCR analyses. In the case of four patients, minor differences in the profiles were obtained by either EK or IR-PCR. The findings suggest that antifungal treatment in this patient group fails to eradicate the original C. albicans strain, thereby allowing recolonisation of the oral cavity. The present study has also shown that either EK or IR-PCR is a useful typing approach in such epidemiological investigations.

Topics: Antifungal Agents; Candida; Candidiasis, Oral; DNA Primers; Electrophoresis; Follow-Up Studies; Genotype; Humans; Itraconazole; Karyotyping; Molecular Epidemiology; Mouth; Nystatin; Polymerase Chain Reaction; Terminally Ill

Topics: Anti-Infective Agents, Local; Antifungal Agents; Candidiasis, Oral; Female; Gentian Violet; Humans; Infant, Newborn; Laryngitis; Nystatin; Tracheitis

Denture biofilms represent a protective reservoir for oral microbes. The study of the biology of Candida in these biofilms requires a reliable model. A reproducible model of C. albicans denture biofilm was developed and used to determine the susceptibility of two clinically relevant C. albicans isolates against 4 antifungals. C. albicans, growing as a biofilm, exhibited resistance to amphotericin B, nystatin, chlorhexidine, and fluconazole, with 50% reduction in metabolic activity (50% RMA) at concentrations of 8, 16, 128, and > 64 microg/mL, respectively. In contrast, planktonically cultured C. albicans were susceptible (50% RMA for the same antifungals was obtained at 0.25, 1.0, 4.0, and 0.5 microg/mL, respectively). In conclusion, results obtained by means of our biofilm model show that biofilm-associated C. albicans cells, compared with cells grown in planktonic form, are resistant to antifungals used to treat denture stomatitis.

Topics: Acrylic Resins; Amphotericin B; Anti-Infective Agents, Local; Antifungal Agents; Biofilms; Candida albicans; Candidiasis, Oral; Chlorhexidine; Colony Count, Microbial; Denture Bases; Dose-Response Relationship, Drug; Drug Resistance, Microbial; Fluconazole; Galactose; Glucose; Humans; Indicators and Reagents; Nystatin; Polymethyl Methacrylate; Saliva; Statistics as Topic; Stomatitis, Denture; Sucrose; Tetrazolium Salts; Time Factors

Topics: Administration, Oral; Adult; Antifungal Agents; Candidiasis, Oral; Dermatitis, Allergic Contact; Dermatitis, Atopic; Diagnosis, Differential; Facial Dermatoses; Humans; Male; Nystatin; Patch Tests

Oropharyngeal candidiasis (OPC) is the most frequent AIDS-associated opportunistic infection, as up to 90% of HIV-infected individuals suffer at least one episode during the course of their disease. Various in vivo and in vitro procedures have been used to assess the effectiveness of antifungal agents used in HIV infection. In the present study, we evaluated in vitro the minimum inhibitory concentration (MIC) and the post-antifungal effect (PAFE) of two polyenes, two azoles and one DNA-analogue against 10 oral isolates of Candida albicans and 10 of Candida tropicalis, all from HIV-infected individuals, in order to obtain basic data on the pharmacodynamics of these drugs. One-hour exposure to twice the MIC of all the drugs, except fluconazole, elicited a consistently high PAFE in both Candida species. Furthermore, the PAFE elicited by the antifungals (except fluconazole) was significantly prolonged for C. tropicalis compared with C. albicans. This speedy recovery of C. albicans isolates exposed to transient low concentrations of antifungals appeared to reflect its virulence compared with lesser potent species, such as C. tropicalis. Taken together, the current data, while confirming the existence of PAFE in a non-albicans species of Candida, also provide further clues for the recalcitrance of C. albicans species in the face of antifungal therapy for oropharyngeal candidiasis.

Topics: AIDS-Related Opportunistic Infections; Amphotericin B; Antifungal Agents; Candida; Candida albicans; Candidiasis, Oral; Fluconazole; Flucytosine; HIV Infections; Humans; Ketoconazole; Microbial Sensitivity Tests; Nystatin; Oropharynx; Pharyngeal Diseases; Statistics as Topic; Time Factors; Virulence

Infection with Candida albicans in the breastfeeding dyad has been associated with extreme pain in the breastfeeding mother and may lead to premature weaning. There is presently a dearth of information on diagnosis, natural history, and treatment of this condition in the literature. Therefore, before such a trial was conducted, a survey was sent to experts in the field of lactation, the members of The Academy of Breastfeeding Medicine, on the diagnosis and treatment of thrush in the breastfeeding mother and baby. Results showed that the majority of respondents relied primarily on history and physical examination of the baby, but not the mother, to make the diagnosis. Laboratory tests were ordered only rarely. The most common initial treatment was oral nystatin for the infant and cream for the mother's breasts. This was followed by oral nystatin for the infant and oral fluconazole for the mother. Treatment of recurrence or persistence was again most commonly nystatin for both mother and infant, followed by oral nystatin for the infant and oral fluconazole for the mother or oral fluconazole for both. In the absence of controlled trials of this condition, these results may serve as suggestions for the clinician, until definitive data are available.

Topics: Adult; Antifungal Agents; Breast Diseases; Breast Feeding; Candidiasis; Candidiasis, Oral; Female; Fluconazole; Humans; Infant; Infant, Newborn; Mouth Diseases; Nipples; Nystatin; Recurrence; Weaning

Post-antifungal effect (PAFE) is defined as the suppression of growth that persists following limited exposure of fungi to antimycotics and subsequent removal of the drug. The fungal pathogen Candida albicans is the major aetiologic agent of oral candidosis, and the cell surface hydrophobicity (CSH) of this yeast is considered a critical factor contributing to its colonisation potential. As the concentration of topically prescribed antifungals reach sub-therapeutic levels at dosage intervals, the study of the polyene-induced PAFE and its impact on the CSH of oral C. albicans should be of clinical relevance. Hence the aims of this investigation were to measure the PAFE and CSH of 12 isolates of C. albicans following limited exposure (1 h) to nystatin and amphotericin B and also to investigate the ultrastructural features of yeast cells following such antifungal exposure. The yeasts were exposed to sub-lethal concentrations of nystatin (x2 MIC) and amphotericin B (x2 MIC) for a period of 1 h. Following subsequent removal of the drug, the PAFE and the CSH of the isolates were assessed by a turbidometric measurement of growth and a biphasic aqueous-hydrocarbon assay, respectively. The mean duration of PAFE of nystatin and amphotericin B were 5.99 (+/-0.49) h and 8.73 (+/-0.93) h, respectively, while the reduction in CSH following exposure to these drugs were 17.32% (P<0.05 for 83% of the isolates) and 14.26% (P<0.05 for 66% of the isolates), respectively. On scanning electron microscopy the exposed cells were seen to undergo collapse of the internal cell membrane, leaving an intact cell wall, while a proportion of cells were deflated. Some cells showed intense puckering of the cell wall, resulting in a mulberry appearance. Taken together, these data elucidate additional mechanisms by which polyene antimycotics may operate in vivo to suppress candidal pathogenicity.

Topics: Amphotericin B; Antifungal Agents; Candida albicans; Candidiasis, Oral; Cell Membrane; Dose-Response Relationship, Drug; Humans; Microbial Sensitivity Tests; Microscopy, Electron, Scanning; Nystatin; Virulence

Strain differentiation of 66 clinical isolates of Candida albicans obtained from healthy dentate and complete denture wearers was performed. Resistogram method based on differences in the resistance of C. albicans isolates to sodium selenite, boric acid, cetrimide, sodium periodate and silver nitrate was used for strain differentiation. Of the 32 potential strains that can be distinguished, 14 different resistogram strains of C. albicans were found among the 66 isolates tested. Strain-C--was the most predominant (24.3% of total isolates), while strain A-CDE was the least predominant (1.5%). The results showed no particular association of certain strains with Candida infections in complete denture wearers. Sensitivity to antifungal agents showed that isolates from different strains were most sensitive to amphotericin B and nystatin and least sensitive to miconazole.

Topics: Amphotericin B; Antifungal Agents; Boric Acids; Candida albicans; Candidiasis, Oral; Cetrimonium; Cetrimonium Compounds; Denture, Complete; Drug Resistance, Microbial; Humans; Miconazole; Microbial Sensitivity Tests; Nystatin; Periodic Acid; Silver Nitrate; Sodium Selenite; Stomatitis, Denture

The purpose of this study was to determine the extent and outcome of antifungal treatment in HIV/AIDS patients. Data obtained from patients attending a hospital-based, semi-urban comprehensive care HIV clinic, were retrospectively analysed. The clinic serves patients from urban, semi-urban and rural communities. A total of 751 confirmed black heterosexual HIV/AIDS patients received routine oral examinations and surveillance swabbing for oral yeast culture. Patients received nystatin solution as prophylaxis, miconazole for clinically detectable oral candidiasis and only in severe cases or cases of chronic candidiasis were they treated with either fluconazole or itraconazole. Treatment was regarded as successful when there was an absence or resolution of clinical lesions of oral candidiasis. Nystatin prophylaxis was prescribed to 7.9% of patients, miconazole treatment to 9.7% and 3.5% received fluconazole. Of the 60 patients who received nystatin prophylaxis, 40 (66.6%) had clinically detectable candidiasis. A negative statistical correlation was found between nystatin prophylaxis and clinically detectable candidiasis. Of 72 patients who received miconazole treatment, only 3 failed to respond. Eleven of the 27 patients who received fluconazole treatment did not return for follow-up visits. In the remaining 16 patients there was no recurrence of clinical symptoms during the following 3 - 24 months after treatment with fluconazole. It is concluded that nystatin prophylaxis proved not to be effective under these particular clinical circumstances. Resistance to azole antifungal medication is not yet a problem in this black heterosexual group of South African HIV/AIDS patients.

Topics: Adolescent; Adult; Aged; AIDS-Related Opportunistic Infections; Antifungal Agents; Candidiasis, Oral; Chemoprevention; Chronic Disease; Cohort Studies; Comprehensive Health Care; Female; Fluconazole; Follow-Up Studies; Heterosexuality; Humans; Itraconazole; Male; Miconazole; Middle Aged; Nystatin; Population Surveillance; Retrospective Studies; South Africa; Treatment Outcome

The post-antifungal effect (PAFE) is defined as the suppression of growth that persists following limited exposure of yeasts to antimycotics and subsequent removal of the drug. Although limited data are available on the PAFE of nystatin on oral isolates of C albicans, there is no information on non-albicans Candida species. As nystatin is the commonest antifungal agent prescribed in dentistry, the main aim of this investigation was to measure the PAFE of oral isolates of Candida belonging to six different species (five isolates each of C. albicans, C. tropicalis, C. krusei, C. parapsilosis, C. glabrata and C. guilliermondii) following limited exposure (1 h) to nystatin. The yeasts were examined for the presence of the PAFE after 1 h exposure to the minimum inhibitory concentration (MIC) of nystatin. The PAFE was determined as the difference in time (h) required for the growth of the drug-free control and the drug-exposed test cultures to increase to the 0.05 absorbance level following removal of the antifungal agent. The mean duration of nystatin-elicited PAFE was lowest for C. albicans (6.85 h) and greatest for C. parapsilosis (15.17 h), while C. krusei (11.58 h), C. tropicalis (12.73 h), C. glabrata (8.51 h), and C. guilliermondii (8.68 h) elicited intermediate values. These findings clarify another intriguing possibility for the persistent, chronic recurrence of oral C. albicans infections despite apparently adequate antifungal drug regimens. The significant variations in nystatin-induced PAFE amongst non-albicans species may also have clinical implications, in terms of nystatin regimens used in the management of these fungal infections.

Topics: Analysis of Variance; Antifungal Agents; Candida; Candidiasis, Oral; Humans; Microbial Sensitivity Tests; Nystatin; Recurrence; Statistics, Nonparametric

Topics: Aged; Antifungal Agents; Candidiasis; Candidiasis, Oral; Dentures; Hand Dermatoses; Humans; Male; Nystatin

Chronic atrophic candidiasis is prevalent in up to 72% of institutionalized geriatric populations and is causally associated with Candida albicans. Topical antifungal treatments are difficult to implement in some geriatric patients due to cognitive impairment, reduced motor dexterity and memory loss.. This in vitro study incorporated antifungal agents into tissue conditioners to investigate the effectiveness of this method of drug delivery.. Combinations of nystatin, fluconazole, itraconazole and Coe Soft, Viscogel, Fitt were tested at 1, 3, 5, 7, 9 and 11 wt/wt%, with and without sterilized saliva. 6 mm diameter cores were punched in Sabouraud plates pre-grown with standardized C. albicans. Antifungal agents plus tissue conditioner mixtures were injected into each core. Inhibition diameters were measured for 14 days.. Cores with only tissue conditioners acted as negative control and showed no significant inhibition activity (ANOVA, p > 0.05). Peak activity was between 65 to 89 hours; followed by a plateau. Itraconazole had greater fungicidal activity than fluconazole; while nystatin was found to have the least fungicidal activity (ANOVA, p < 0.05). The most effective concentration for nearly all combinations was 5% wt/wt (ANOVA, p < 0.05). Specimens with saliva showed greater antifungal activity than those without (t-test, p < 0.001). Itraconazole altered the physical properties of Viscogel hence this combination is not recommended for clinical use.. The treatment of chronic atrophic candidiasis by incorporation of antifungal drugs into tissue conditioners is efficacious. 5% wt/wt itraconazole mixed with Coe Soft or Fitt is recommended for clinical study where compliance of patient or care giver cannot be relied upon. Peak antifungal activity at 3 days suggests that mixtures prepared for clinical study may be replaced soon after this time for maximum effectiveness.

Topics: Acrylic Resins; Aged; Analysis of Variance; Antifungal Agents; Candida albicans; Candidiasis, Oral; Dental Care for Aged; Denture Liners; Drug Combinations; Drug Delivery Systems; Fluconazole; Humans; Itraconazole; Methylmethacrylates; Microbial Sensitivity Tests; Nystatin; Phthalic Acids; Statistics, Nonparametric; Stomatitis, Denture; Tissue Conditioning, Dental

Candidal adherence has been implicated as the first step in the pathogenesis of oral candidosis, and germ tube formation by Candida albicans has been attributed as a co-factor that promotes adherence. Oral candidosis is treated with polyenes and the azole group of antifungal agents. As the intraoral concentrations of antifungals fluctuate considerably due to the dynamics of the oral cavity, we investigated the effect of short exposure to sub-lethal concentrations of antifungals on the germ tube formation of Candida albicans. After determining the minimum inhibitory concentration (MIC) of the antifungal agents, ten oral isolates of Candida albicans were exposed to sub-lethal concentrations of nystatin (6xMIC), amphotericin B (8xMIC), 5-fluorocytosine (8xMIC), ketoconazole (4xMIC) and fluconazole (4xMIC), for 1 h. Following removal of the antifungal agent and subsequent incubation in a germ tube-inducing medium, the germ tube formation of these isolates was quantified. When compared with the controls, exposure to nystatin and amphotericin B almost completely inhibited germ tube formation of all the isolates (mean percentage reduction of 97.68 and 97.52%, respectively; P<0.0001), while ketoconazole suppressed this activity to a lesser degree (30.84%; P=0.0174). However, 5-fluorocytosine- and fluconazole-mediated germ tube suppression was minimal (12.63 and 15.93%, respectively; P=0.3255 and P=0.3791). In clinical terms, these findings indicate that short exposure to sub-therapeutic levels of commonly prescribed antifungals may modulate candidal germ tube formation, and thereby the clearance of the organisms from the oral cavity.

Topics: Adhesiveness; AIDS-Related Opportunistic Infections; Amphotericin B; Antifungal Agents; Candida albicans; Candidiasis, Oral; Culture Media; Dose-Response Relationship, Drug; Fluconazole; Flucytosine; HIV Seronegativity; Humans; Ketoconazole; Microscopy, Electron, Scanning; Mouth; Nystatin

Candidal adherence to denture acrylic surfaces is implicated as the first step in the pathogenesis of Candida-associated denture stomatitis, the most prevalent form of oral candidosis in the West. This condition is treated by topically administered antifungal agents, mainly belonging to the polyenes and azoles. As the intraoral concentrations of antifungals fluctuate considerably due to the dynamics of the oral environment, the effect of short exposure to sublethal concentrations of antifungals on the adhesion of Candida albicans to denture acrylic surfaces was investigated. Seven oral C. albicans isolates were exposed to four-eight times minimum inhibitory concentrations (MIC) of five antifungal drugs, nystatin, amphotericin B, 5-fluorocytosine, ketoconazole and fluconazole, for 1 h. After removing the drug (by repeated washing) the adhesion of these isolates to acrylic strips was assessed by an in vitro adhesion assay. Exposure to antifungal agents significantly reduced the adherence of all seven C. albicans isolates to denture acrylic. The mean percentage reductions of adhesion after limited exposure to nystatin, amphotericin B, 5-fluorocytosine, ketoconazole and fluconazole were 86.48, 90.85, 66.72, 65.88 and 47.42%, respectively. These findings indicate that subtherapeutic doses of antifungals may modulate oral candidal colonization. Further, these results may have an important bearing on dosage regimens currently employed in treating oral candidosis.

Topics: Adhesiveness; Administration, Topical; Amphotericin B; Analysis of Variance; Antifungal Agents; Candida albicans; Candidiasis, Oral; Denture Bases; Drug Administration Schedule; Fluconazole; Flucytosine; Humans; Image Processing, Computer-Assisted; Ketoconazole; Mouth; Nystatin; Polymethyl Methacrylate; Stomatitis, Denture; Surface Properties; Time Factors

Buccal epithelial cells (BEC) from 12 patients with diabetes mellitus and 12 age- and sex-matched non-diabetic subjects were tested in vitro for adhesion of Candida albicans following exposure to nystatin both in vitro and in vivo. Adhesion was significantly reduced (P < 0.002) to cells from both the diabetic and non-diabetic subjects after in vitro exposure to nystatin, but the reduction in adhesion was variable (5.0-50.7% in control subjects and 0.5-48.4% in diabetic subjects) and equivalent between the two groups. In vivo exposure to nystatin produced no overall significant reduction in candidal adhesion to cells from either diabetic or control subjects.

Topics: Adult; Antifungal Agents; Candida albicans; Candidiasis, Oral; Case-Control Studies; Cell Adhesion; Diabetes Complications; Diabetes Mellitus; Epithelial Cells; Epithelium; Female; Humans; Male; Mouth Mucosa; Nystatin

Topics: AIDS-Related Opportunistic Infections; Ambulatory Care; Amphotericin B; Antifungal Agents; Candidiasis, Oral; Esophagitis; Fluconazole; Guidelines as Topic; Humans; Itraconazole; Ketoconazole; Medical Audit; Nystatin; Retrospective Studies

The clinical feature of 20 cases with oral candidiasis in Sjögren's syndrome (SS) were reported, and the treatment effect by topical nystatin smearing, 2% sodium bicarbonate solution rinsing, and transfer factor injecting for about 2 months were analysed. The results showed that the diagnostic criterion of oral candidiasis in SS included two aspects: the SS changes confirmed by labial gland biopsy and candidal hyphae and spores found in a smear. The results indicated that the comprehensive treatments were proved to be effective for oral candidiasis in SS.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Antifungal Agents; Candidiasis, Oral; China; Female; Humans; Male; Middle Aged; Nystatin; Prevalence; Sjogren's Syndrome; Transfer Factor

Clinical audit revealed that the treatment of oral candidosis was more successful with nystatin pastilles than with nystatin suspension. The purpose of this investigation was to determine the reasons for this observation. The concentration of nystatin needed to kill 49 consecutive clinical isolates of Candida albicans was measured. The isolates varied in cidal concentrations from 1.875 to 30 U/ml. The time taken to kill these isolates at their cidal concentrations was found to vary from 120 to 300 min. Volunteer studies showed that antifungal activity in the oral cavity was eliminated rapidly after the use of nystatin suspension. In contrast, the polyene could be detected for at least 5 hours after use of the nystatin pastille. The nystatin pastille can be expected to be more effective at killing Candida albicans than the suspension due to its persistent effects.

Topics: Antifungal Agents; Candida albicans; Candidiasis, Oral; Female; Humans; Male; Medical Audit; Mouth; Nystatin; Polyenes; Solutions; Tablets; Time Factors; Treatment Outcome

Topics: Antifungal Agents; Asthma; Betamethasone; Candidiasis, Oral; HIV Seronegativity; Humans; Ketoconazole; Leukoplakia, Hairy; Male; Middle Aged; Nystatin

Topics: Acquired Immunodeficiency Syndrome; AIDS-Related Opportunistic Infections; Amphotericin B; Antifungal Agents; Antiprotozoal Agents; Antiviral Agents; Atovaquone; Candidiasis, Oral; Clindamycin; Clotrimazole; Cryptosporidiosis; Cytomegalovirus Infections; Dapsone; Didanosine; Drug Combinations; Drug Therapy, Combination; Fluconazole; Flucytosine; Folic Acid Antagonists; Foscarnet; Glucuronates; Herpes Simplex; Herpes Zoster; Humans; Isoniazid; Itraconazole; Ketoconazole; Lamivudine; Mycobacterium avium-intracellulare Infection; Naphthoquinones; Nystatin; Pentamidine; Pneumocystis Infections; Pneumonia, Pneumocystis; Prednisone; Primaquine; Reverse Transcriptase Inhibitors; Stavudine; Syphilis; Toxoplasmosis; Trimetrexate; Tuberculosis; Zalcitabine; Zidovudine

Mucosal oral therapeutic system (MOTS) is a controlled-release osmotic system for oral cavity therapy. MOTS (nystatin) is designed to deliver approximately 200,000 units of nystatin over several hours. A crossover study was conducted in five healthy volunteers to evaluate the amount of nystatin released (based on residual drug content) when the system is held in the mouth for 30 min, 1 h, and 2 h, and to compare these concentrations with those achieved with a Mycostatin (nystatin) pastille. An average of 37% of the nystatin content was released intra-orally from MOTS during 2 h in the mouth, which was very similar to the percentage delivered in vitro. Mean salivary drug concentrations were as follows: 279 micrograms.ml-1 at 30 min; 654 micrograms.ml-1 after 1 h; and 532 micrograms.ml-1 at 2 h. These concentrations consistently exceeded those produced by the pastille at the same time points. Fifteen minutes after placement of the pastille in the mouth (i.e., immediately after its dissolution) mean nystatin concentrations reached 746 micrograms.ml-1 but fell rapidly to 13.2 micrograms.ml-1 at 30 min, 7.2 micrograms.ml-1 at 1 h, and 5.6 micrograms.ml-1 at 2 h. The study demonstrates that MOTS maintains high salivary nystatin concentrations throughout a 2 h dosing interval.

Topics: Administration, Oral; Adolescent; Adult; Candidiasis, Oral; Drug Delivery Systems; Female; Humans; Middle Aged; Nystatin; Saliva; Tablets

Microbiological evaluation of oral cavity was performed in 112 children, aged 6-18 years, with retrogenic defects (group I) and other defects (group II). The material for microbiological investigation consisted of contents of oral cavity cultured on the Sabouraud broth. Isolated abacterial strains of fungi were differentiated according to their morphological and biochemical properties. Among isolated fungi, independently of the bite defects and age of children, highest percentage of strains of Candida albicans was noted. Remaining species represented genus Candida (C. glabrata, C. guilliermondii, C. krusei, C. parapsilosis, C. pseudotropicalis, C. zeylanoides), Geotrichum (G. candidum), Rhodotorula (R. rubra) and Trichosporon (T. cutaneum). Fungi were present in oral cavity in 45% (age 6-8 years) and 36.4% (age 9-18 years) of group I patients. In group II these percentages were respectively 15.2 and 58.7. In control groups occurrence of fungi was 3-4 times lower. Despite application of disinfectants and treatment with nystatin, frequency of isolation of fungi did not change.

Topics: Adolescent; Candida; Candidiasis, Oral; Child; Disinfectants; Humans; Nystatin; Orthodontic Appliances; Species Specificity; Treatment Outcome

Congenital candida infection is a rare disease, although the incidence of candida vaginitis during pregnancy is high. We report on five cases each showing patterns considered typical for candida infection. The infective agent can cause chorioamnionitis even in the presence of intact fetal membranes. An intrauterine device (IUD) has been proved to be a risk factor for a congenital candida infection. The pathogenetic significance of contamination with candida for the fetus appears to depend largely on gestational age. A premature infant with a birth-weight less than 1500 g presented with bilateral candida endophthalmitis which was cured by intravenous Fluconazole therapy. Another premature infant weighing 800 g at birth developed a systemic candida infection. The other three more mature infants had milder symptoms, two of them presented with cutaneous candidiasis.

Topics: Adult; Amniocentesis; Amphotericin B; Candidiasis; Candidiasis, Cutaneous; Candidiasis, Oral; Candidiasis, Vulvovaginal; Chorioamnionitis; Drug Therapy, Combination; Endophthalmitis; Female; Fetal Membranes, Premature Rupture; Flucytosine; Humans; Infant, Newborn; Infant, Premature, Diseases; Male; Nystatin; Pregnancy

The results are presented of in vitro investigations of the sensitivity of 225 strains of yeast-like fungi to nystatin. The strains were isolated from cutaneous and mucosal lesions. In the study nystatin concentration 10 micrograms/ml of the substrate was used and a two-grade scale of evaluation was applied: sensitive or resistant to the drug. It was found that 56.7% of the tested strains were resistant to this nystatin concentration. The obtained data were compared with those obtained in 1972 when all the tested strains were sensitive to nystatin in this concentration. The study showed that the resistance to nystatin has been rising in these organisms with years.

Topics: Candida; Candida albicans; Candidiasis; Candidiasis, Cutaneous; Candidiasis, Oral; Culture Media; Drug Resistance, Microbial; Female; Humans; In Vitro Techniques; Male; Microbial Sensitivity Tests; Nystatin

Oral candidosis is an increasingly important disease that affects a significant percentage of the population. Traditionally known as an opportunistic pathogen, the broader clinical scope of oropharyngeal candidal infections is now being recognized. The clinical and historical features of 100 patients referred for diagnosis and management of candidosis have been reviewed. The age, gender, chief complaint, medical history, medications, and clinical findings have been noted. A wide range of clinical signs and symptoms, and the rationale behind the topical and systemic antifungal therapies provided to this patient population, are discussed.

Topics: Administration, Oral; Administration, Topical; Antifungal Agents; Candidiasis, Oral; Chlorhexidine; Clotrimazole; Female; Humans; Ketoconazole; Male; Middle Aged; Mouthwashes; Nystatin

Topics: Candidiasis, Oral; Carbohydrates; Dental Caries; Drug Combinations; Humans; Nystatin

Topics: Candidiasis, Oral; Drug Eruptions; Female; Humans; Infant; Nystatin; Stevens-Johnson Syndrome

The concentrations of nystatin excreted with faeces during and after oral application of 3 x 150,000 IU/d, either continuously for 14-21 days or every second day were determined in 42 newborns at risk by means of a bioassay (agar diffusion test). Results indicate that nystatin is distributed heterogeneously in the gastrointestinal tract. The excretion occurs discontinuously. 24 to 48 h after beginning of therapy there were effective concentrations of nystatin in the faeces. The daily application of 3 x 150,000 IU nystatin is recommended.

Topics: Biological Availability; Candidiasis, Cutaneous; Candidiasis, Oral; Diaper Rash; Dose-Response Relationship, Drug; Drug Administration Schedule; Feces; Humans; Infant, Newborn; Infant, Premature, Diseases; Metabolic Clearance Rate; Nystatin; Risk Factors

Topics: Candidiasis, Oral; Humans; Nystatin

Oral mucosal surfaces from 54 patients seropositive for human immunodeficiency virus (HIV) were assayed for the presence of cultivable yeasts. Oral colonization with Candida albicans, represented by 6 biotypes, was evident in 35 persons. The closely related variant, Candida stellatoidea, was found in 3 patients. Single isolates of Candida parapsilosis, Candida glabrata, Candida tropicalis, and Candida paratropicalis were also identified. One patient harbored a population of Saccharomyces cerevisiae. The susceptibilities of these 43 isolates to clotrimazole and nystatin were compared by the disk diffusion technique.

Topics: Candida; Candida albicans; Candidiasis, Oral; Clotrimazole; HIV Infections; Humans; Microbial Sensitivity Tests; Mouth Mucosa; Nystatin; Saccharomyces cerevisiae

A pathologic condition is described, characterized by rampant necrosis of gingival mucosa, periodontium, and related osseous structures associated with systemic infection with the human immunodeficiency virus (HIV). It is believed that this condition is an extension beyond the normal clinical course of HIV-periodontitis (HIV-P) and manifests itself in three progressive stages: (1) HIV-associated gingivitis, (2) HIV-P, and (3) an extension of HIV-P to osseous necrosis. Two cases of osseous destruction attending HIV-P are reported, one of which led to initial diagnosis of HIV infection. They represent the final stage of disease progression with localized necrosis of gingiva, periodontium, and alveolar bone.

Topics: Adult; Alveolar Bone Loss; Candidiasis, Oral; Female; Gingivitis, Necrotizing Ulcerative; HIV Infections; Humans; Male; Nystatin; Penicillins; Periodontitis

Antibody-dependent cellular cytotoxicity (ADCC) and lymphocyte-induced angiogenesis (LIA) of mononuclear leucocytes (MNC) isolated from the peripheral blood of patients with denture stomatitis mycotic were examined. The obtained results have shown a decrease in ADCC in patients with mycotic infection of oral cavity. Similarly, the ability to induce angiogenesis by MNC isolated from these patients was decreased in comparison with angiogenesis induced by control MNC. After the anti-mycotic treatment, an increase in ADCC and LIA was noted.

Topics: Animals; Candidiasis, Oral; Cytotoxicity Tests, Immunologic; Humans; Immunity, Cellular; Leukocytes, Mononuclear; Mice; Mice, Inbred BALB C; Middle Aged; Neovascularization, Pathologic; Nystatin; Polyenes; Stomatitis; Stomatitis, Denture

Oropharyngeal candidiasis occurred in a previously healthy young Israeli homosexual male. Additional symptoms included persistent diarrhea, weight loss, fever, generalized lymphadenopathy and peripheral neuropathy. Immunologic studies revealed lymphopenia with reversed T-helper/T-suppressor cells ratio and antibodies to human immunodeficiency virus, all compatible with the diagnosis of subclinical AIDS. Repeated courses of antimonilial treatment failed to eradicate the oropharyngeal lesions. The clinical picture of AIDS, particularly its oral manifestations, is described. The diagnostic and prognostic implications of oropharyngeal candidiasis as a presenting sign of the disease are discussed. In addition, precautionary measures that should be taken when treating persons infected with HIV are described.

Topics: Acquired Immunodeficiency Syndrome; Adult; Candidiasis, Oral; Humans; Male; Nystatin

Polyene antibiotics such as nystatin and amphotericin B are among the most widely recommended drugs for use in the treatment of oral candidiasis. It is also generally accepted that chlorhexidine gluconate is an appropriate adjunct or an alternative to specific antimycotic drugs. The aim of the present paper was to discuss the conventional treatment against Candida albicans infections. It has previously been shown in an vitro study that combination of chlorhexidine and nystatin reduced the effect against Candida albicans. The most likely reason is that a low solubility chlorhexidine-nystatin salt is formed, thus rendering the combined drug complex ineffective as an antibiotic agent. Other pharmacologic interactions are also discussed. In the treatment of denture related candidiasis one should keep in mind that some tissue conditioners will inhibit the antifungal activity of amphotericin B. A more restrictive use of combinations of drugs against oral candidiasis is suggested.

Topics: Candidiasis, Oral; Chlorhexidine; Drug Therapy, Combination; Humans; Nystatin

Infection of the oral mucous membrane is frequent in patients with removable prostheses, either totally of partially, and particularly when the prostheses is palatal. The principal etiological factor causing the infection is accepted to be "Candidas" aided by the presence of plaque bacteria (in patients with poor oral hygiene care), and a poor fit of the prostheses to the soft tissues. Treatment of the infection must proceed in the following order: a) use of effective medication against oral fungus such as Nystatin or Ketoconazole. b) Meticulous oral hygiene care in the mucous membrane as well as in the prostheses, but using the prostheses as little as possible during the treatment period. c) A total cure of the infection (denture stomatitis) before proceeding to the next phase of the treatment. d) Determination of the adjustment and occlusion of the prostheses in order to determine those areas of the prostheses which need to be refilled because of maladjustment of the prostheses to the soft tissues of the patient.

Topics: Candidiasis, Oral; Chlorhexidine; Denture, Complete; Humans; Ketoconazole; Nystatin; Oral Hygiene; Stomatitis; Stomatitis, Denture

Polyene antibiotics such as nystatin and amphotericin B are among the most widely recommended drugs for use against oral candidiasis. It is also generally accepted that chlorhexidine gluconate is an appropriate adjunct or an alternative to specific antimycotic drugs. The aim of the present study was to examine the effect of the combination of nystatin and chlorhexidine digluconate on Candida albicans in vitro. The minimum inhibitory concentration (MIC) value for the combination of the two drugs was found to be significantly higher than the values for each of the drugs alone, approximately 33 times the MIC value for the nystatin solution and 4 times the value for chlorhexidine digluconate. The results of the MIC study and the presence of a precipitate in all combinations of nystatin and chlorhexidine digluconate showed that the combination of the drugs is not effective in vitro against Candida albicans. The most likely reason is that a low solubility chlorhexidine-nystatin salt is formed, thus rendering the combined drug complex ineffective as an antibiotic agent.

Topics: Candida albicans; Candidiasis, Oral; Chemical Precipitation; Chlorhexidine; Drug Combinations; Drug Incompatibility; Drug Resistance, Microbial; Drug Synergism; Humans; Nystatin

Ketoconazole suspension (20 mg per ml) was compared with nystatin (100,000 units per ml) in the treatment of oral candidosis in newborns and infants. In all patients Candida infection was proven by culture. Twenty patients were treated with ketoconazole and 15 patients with nystatin. Treatment was discontinued 2 days after clinical cure, or after 3 weeks. The investigator assessed the severity of the thrush and accompanying symptoms at the start of the study and at weekly controls. After one week all 20 patients on ketoconazole (100%) and 8 (53%) patients on nystatin were cured clinically. At the end of the treatment 12 patients on nystatin (80%) were cured. Clinical cure was confirmed by negative culture in 94% of the patients on ketoconazole and in 73% of the patients on nystatin. No side-effects were observed in the patients on ketoconazole. Only in the case of one patient on nystatin, was vomiting observed. This study shows that ketoconazole cures thrush faster and more effectively than nystatin.

Topics: Candidiasis, Oral; Child, Preschool; Humans; Infant; Infant, Newborn; Ketoconazole; Nystatin; Suspensions

Topics: Candidiasis, Oral; Clotrimazole; Humans; Imidazoles; Nystatin; Transaminases

Topics: Acquired Immunodeficiency Syndrome; Adult; Candidiasis, Oral; Humans; Male; Nystatin

Topics: Adult; Aged; Candida albicans; Candidiasis, Oral; Chlorhexidine; Denture, Complete; Disinfection; Female; Humans; Male; Middle Aged; Mouth; Mouthwashes; Nystatin; Stomatitis; Stomatitis, Denture

Topics: Candida; Candidiasis, Oral; Female; Humans; Male; Mouth Diseases; Nystatin; Scotland; Terminal Care

Topics: Candida; Candidiasis, Oral; Humans; Nystatin

Topics: Adult; Aged; Atrophy; Candida albicans; Candidiasis, Oral; Cheilitis; Chronic Disease; Denture, Complete, Upper; Drug Resistance, Microbial; Female; Humans; Male; Middle Aged; Nystatin; Stomatitis; Stomatitis, Denture; Tablets

Topics: Amphotericin B; Candidiasis, Cutaneous; Candidiasis, Oral; Child; Esophagitis; Female; Humans; Ketoconazole; Leukemia, Lymphoid; Male; Nystatin; Thrombocytopenia

Topics: Candidiasis, Oral; Child, Preschool; Humans; Male; Nystatin; Otitis Media

Sensitivity of 146 clinical strains of Candida albicans to nystatin, levorin and amphoglucamine was studied on solid media with the replica method. The strains were isolated from 79 patients with candidiasis of the oral mucosa. It was found that sensitivity of the fungi to the polyenic antibiotics was different which should be considered in treatment of candidiasis. On the basis of the mean MICs for the clinical strains and their distribution by the MICs it was shown that the activity level of levorin and amphoglucamine was higher than that of nystatin. During the treatment resistance of the Candida strains to the polyenic antibiotics increased and cross resistance developed which required application of other treatment means.

Topics: Amphotericin B; Antifungal Agents; Candicidin; Candida albicans; Candidiasis, Oral; Drug Resistance, Microbial; Humans; Nystatin

Thirty-three patients with acute leukemia or lymphoma received an ongoing topical treatment with an oral suspension of nystatin during prolonged periods of intensive chemotherapy and severe granulocytopenia. The preparation proved ineffective in eliminating colonized Candida species from the oropharynx in ten of eleven patients at the time of admission and was of questionable value in preventing later colonization in others. The difficulties surrounding the identification of systemic candidiasis, its significance in the immunosuppressed patient, and the role of topical antifungal prophylaxis are discussed.

Topics: Adolescent; Adult; Aged; Candida; Candidiasis, Oral; Female; Humans; Immunosuppression Therapy; Leukemia; Lymphoma; Male; Middle Aged; Nystatin; Oropharynx; Pharyngeal Diseases

Topics: Candidiasis, Oral; Chlorhexidine; Dental Plaque; Denture, Complete; Humans; Nystatin; Stomatitis; Stomatitis, Denture

Topics: Adult; Aged; Candidiasis, Oral; Drug Evaluation; Female; Hodgkin Disease; Humans; Male; Middle Aged; Mouth Neoplasms; Natamycin; Nystatin; Radiotherapy; Radiotherapy Dosage; Time Factors

Topics: Candidiasis, Oral; Humans; Miconazole; Nystatin; Stomatitis

Two cases of oral candidiasis are described which failed to respond to nystatin therapy when used in combination with triamcinolone acetonide. The isolates of C. albicans obtained from the patients after treatment showed high in vitro resistance to nystatin when tested in combination with triamcinolone acetonide. Triamcinolone acetonide was detected in the saliva of both patients after treatment. Addition of this saliva to the isolates of C. albicans obtained after treatment was found to confer nystatin resistance. Both patients were treated with miconazole nitrate and a mycological and clinical cure was obtained in one of the cases.

Topics: Aged; Candida albicans; Candidiasis, Oral; Drug Combinations; Drug Resistance, Microbial; Female; Humans; Middle Aged; Nystatin; Triamcinolone Acetonide

Topics: Adolescent; Adult; Aged; Candidiasis; Candidiasis, Oral; Female; Humans; Lip Diseases; Male; Middle Aged; Nystatin; Sunlight

Ninety-three hospitalizations of 70 patients, who underwent induction chemotherapy for acute leukemia to determine the effectiveness of oral nystatin in preventing oropharyngeal and systemic candidiasis were reviewed. Sixty-two percent of patients who received prophylactic nystatin and 58% of patients who did not receive nystatin developed oropharyngeal candidiasis; 11% of patients who received prophylaxis and 21% of those who did not receive prophylaxis developed systemic candidiasis. The use of oral nystatin did not significantly diminish the risk of developing either type of Candida infection. Oropharyngeal candidiasis occurred more commonly in patients who had severe and prolonged leukopenia, had received more parenteral antibiotics, and had developed chemotherapy-induced mucositis. Systemic candidiasis developed almost exclusively in patients who had prior oropharyngeal candidiasis. Guidelines for the empiric use of amphotericin B in these patients are provided.

Topics: Administration, Oral; Adult; Candidiasis; Candidiasis, Oral; Female; Humans; Leukemia; Leukemia, Lymphoid; Male; Nystatin

Topics: Candidiasis, Oral; Humans; Nystatin

A human study of the effects of topical nystatin (Mycostatin) therapy of oral candidiasis showed that effects of treatment were limited to the time in which the drug was used. Two weeks of therapy resulted in significant reduction in number of organisms and marked improvement in signs and symptoms of candidiasis. The condition recurred rapidly following cessation of treatment. No change in specific anticandida antibody in saliva or in adherence of Candida albicans to mucosal epithelium (in vitro) was seen with treatment.

Topics: Antibodies, Fungal; Candida albicans; Candidiasis, Oral; Humans; Mouth Mucosa; Nystatin; Recurrence; Saliva

Topics: Administration, Oral; Candidiasis, Oral; Clotrimazole; Humans; Imidazoles; Infant; Male; Nystatin

This article deals with the etiology, pathogenesis, clinical manifestations, diagnosis, and treatment of oral candidosis. Emphasis is placed on drug therapy, and the literature reviewed indicates that although many drugs are available, amphotericin B (10 mg. lozenges) is favored as the drug of choice in the treatment of this condition. Attention is drawn to predisposing factors, particularly diabetes mellitus. A case in which the pathogen was identified as Candida parapsilosis is reported.

Topics: Amphotericin B; Candida; Candidiasis, Oral; Deficiency Diseases; Humans; Male; Middle Aged; Nystatin

Chronic candidiasis of the oral cavity and esophagus may present with a varying clinical picture. Three cases of this entity are presented. Infection occurs when the ecologic balance of normal flora and local factors are upset. Predisposing factors are listed. The different presentations, methods of evaluation, diagnosis, treatment alternatives, and immunologic applications are discussed. The problems of the chronic form of the disease, with it becoming deeply ingrained and recurrent, are stressed.

Topics: Candidiasis, Oral; Chronic Disease; Esophageal Diseases; Female; Humans; Middle Aged; Nystatin

Topics: Candidiasis, Cutaneous; Candidiasis, Oral; Dermatomycoses; Diagnosis, Differential; Griseofulvin; Humans; Nystatin; Tinea

Topics: Candidiasis, Oral; Humans; Nystatin

Topics: Candida albicans; Candidiasis, Cutaneous; Candidiasis, Oral; Enteritis; Feces; Humans; Infant; Nystatin

Many patients with oral candidiasis respond very slowly or not at all to therapy with amphotericin. Strains of Candida albicans were collected from 17 patients clinically resistant and from 15 who responded to a normal course of amphotericin treatment. Minimal inhibitory concentrations (MIC) determined on diagnostic sensitivity test agar plates gave values of: amphotericin 0-5 mg/l; nystatin 50 i.u./ml; chlorhexidine 12.5 mg/l. No clear MIC could be determined with plates containing miconazole. No difference was noted in MIC values between the 2 groups of patients. Tube-dilution tests in Sabouraud's broth gave MIC values of: amphotericin 0.25 mg/l; nystatin 12.5 i.u./ml; chlorhexidine 1.5 mg/l; miconazole 8-32 mg/l; ketonazole 64 mg/l. Persistence of oral candidiasis is not an indication of infection with resistant organisms. Despite difficulties in in vitro sensitivity testing of miconazole a clinical trial of the drug for treating oral candidiasis is indicated.

Topics: Amphotericin B; Antifungal Agents; Candida albicans; Candidiasis, Oral; Chlorhexidine; Chronic Disease; Drug Resistance, Microbial; Humans; Miconazole; Microbial Sensitivity Tests; Nystatin

Topics: Adult; Candidiasis; Candidiasis, Oral; Drug Evaluation; Drug Therapy, Combination; Follow-Up Studies; Humans; Liver Transplantation; Male; Nystatin; Postoperative Care

The authors present a review of the epidemiology, pathology, diagnosis and treatment of candidiasis in the child. Their studies on the favoring factors in cutaneous forms as well as their experiences in pulmonary forms are emphasized.

Topics: Amphotericin B; Candidiasis; Candidiasis, Cutaneous; Candidiasis, Oral; Candidiasis, Vulvovaginal; Child; Clotrimazole; Complement C5; Female; Flucytosine; Humans; Immunity, Cellular; Immunologic Deficiency Syndromes; Miconazole; Nystatin

The therapy of denture sore mouth which is induced by Candida albicans must take its bearings about the general and local disposition factors. The crucial points of stomatological treatment are pointed to. The problems related to local antimycotic therapy in the oral cavity are discussed. A new antimycotic dosage form, the nystatin-gelatin foil, for local application in denture wearers in presented. Its dosage and its use are described.

Topics: Administration, Topical; Bandages; Candidiasis, Oral; Gelatin; Humans; Nystatin; Stomatitis; Stomatitis, Denture

The authors describe the formula and the manufacture of nystatin-gelatin foils that are a new dosage form for local application in case of denture sore mouth induced by Candida albicans. It is pointed to the requirements that a pharmaceutically used gelatin should meet. Furthermore, the authors discuss biopharmaceutical aspects of the nystatin-gelatin foil.

Topics: Candidiasis, Oral; Citrates; Drug Compounding; Gelatin; Humans; Nystatin; Stomatitis; Stomatitis, Denture

A 55-year-old male patient with no significant medical history or systemic physical findings was found, on routine dental examination, to have an oral Candida albicans infection. The condition failed to clear completely after 21 days of nystatin therapy. A 5-day course of clotrimazole was then initiated. Complete clearing of all signs of candida infection occurred in 48 hours, but the infection recurred by the twentieth day of follow-up. A 14-day regimen was then prescribed. Again, the condition cleared in 48 hours, and at the 6-month follow-up all signs of candida involvement, including cultures and smears, remained negative. As no reports of the use of clotrimazole vaginal tablets in oral candidiasis clinically refractory to nystatin therapy were found in the literature of the last 11 years, it was thought that this case was of significant interest.

Topics: Administration, Oral; Candida albicans; Candidiasis, Oral; Clotrimazole; Drug Resistance, Microbial; Humans; Imidazoles; Male; Middle Aged; Nystatin; Recurrence; Suppositories; Tablets

Topics: Candidiasis, Oral; Candidiasis, Vulvovaginal; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature, Diseases; Nystatin; Pregnancy; Pregnancy Complications, Infectious

Topics: Candidiasis; Candidiasis, Oral; Humans; Leukemia; Lymphoma; Nystatin

Topics: Candidiasis, Oral; Humans; Infant, Newborn; Infant, Newborn, Diseases; Nystatin

Topics: Aged; Candidiasis, Oral; Female; Geotrichum; Humans; Mitosporic Fungi; Nystatin; Tongue Diseases; Tongue, Hairy

When there is a suspicion of the presence of a mycosis an exact diagnosis is necessary. Apart from the qualitative and quantitative culture to this also belongs an analysis of mycological kinds and a testing of the resistance against antimycotic drugs. The culture of primarily resistant yeast strains and the observation of a change of the mycological causative organisms render this demand urgent.

Topics: Antifungal Agents; Candidiasis, Oral; Drug Resistance, Microbial; Humans; Miconazole; Mycoses; Nystatin

The case of a 38-year-old male patient with chronic recurrent oropharyngo-esophageal candidiasis since early childhood, resistant to topical therapy with nystatin, is reported. The disease had resulted in impressive oropharyngeal lesions and stricturing of the midesophagus. Extensive in vivo and in vitro immunological studies done before and after successful treatment with miconazole showed a persistent partial deficiency of the cell-mediated immune system, in particular that directed toward candida antigens. Miconazole, a new potent antifungal drug, proved effective in controlling the candidiasis, which had become resistant to conventional treatment.

Topics: Adult; Candidiasis; Candidiasis, Oral; Drug Resistance, Microbial; Esophageal Diseases; Humans; Imidazoles; Immunity, Cellular; Immunologic Deficiency Syndromes; Male; Miconazole; Nystatin; Pharyngeal Diseases

Seventy-four patients wearing full upper and lower dentures were examined in the study; 37 exhibited varying degrees of denture sore mouth (DSM) while the remaining 37 patients acted as controls. Denture trauma was more common in the DSM group. Candida was grown from 73 per cent of patients with DSM but only from 22 per cent of controls. Control patients had better denture hygiene than DSM patients. One year later 22 of the original DSM patients wearing newly made dentures were re-examined. Nine out of 22 still exhibited varying degrees of DSM. In the 9 cases persisting, a nystatin-chlorhexidine treatment plan was prescribed, resulting in resolution of 7 further cases. The cases that failed resolve were wearing unstable traumatogenic new dentures.

Topics: Aged; Candida; Candidiasis, Oral; Chlorhexidine; Dental Occlusion, Traumatic; Denture Retention; Denture, Complete, Upper; Female; Follow-Up Studies; Humans; Male; Middle Aged; Nystatin; Oral Hygiene; Stomatitis; Stomatitis, Denture

Topics: Age Factors; Candidiasis; Candidiasis, Cutaneous; Candidiasis, Oral; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature, Diseases; Mouth Diseases; Nystatin; Rectum; Skin

Uremia is defined as the accumulation of nitrogenous waste products in the blood. Uremia may be caused by either acute or chronic renal failure. Uremic stomatitis represents a relatively uncommon intraoral complication of uremia. Uremic stomatitis has classically been divided into ulcerative and nonulcerative types. Reported here is a patient with chronic renal failure exhibiting intraoral lesions that persisted despite local treatment but rapidly cleared following renal dialysis. This case represents the first published report of the microscopic appearance of the nonulcerative type and presents unusual tissue changes heretofore unreported.

Topics: Adult; Biopsy; Candidiasis, Oral; Coloring Agents; Diagnosis, Differential; Dihydroxyphenylalanine; Humans; Hydrogen Peroxide; Male; Mycoses; Nystatin; Renal Dialysis; Stomatitis; Tetracycline; Uremia

Recurrent nonspecific stomatitis may be an oral sign of pernicious anemia. Repeated examinations and blood studies are important when the cause of stomatitis is not clear on initial evaluation of a complaint of sore mouth. Three cases of pernicious anemia are presented to illustrate the similarities and differences in oral signs of pernicious anemia.

Topics: Adult; Anemia, Macrocytic; Anemia, Pernicious; Candida albicans; Candidiasis, Oral; Female; Glossitis; Humans; Male; Middle Aged; Nystatin; Stomatitis; Vitamin B 12

21 of 41 patients developed clinically manifest or systemic Candida albicans infection 1-36 months after renal transplantation. Asymptomatic candiduria was diagnosed in all patients even before the onset of clinical symptoms. Fungal stomatitis was the most frequent clinical sign, followed by mycotic changes in the respiratory, genito-urinary (vaginitis) and gastro-intestinal tract. In five cases intrahepatic biliary stasis was diagnosed in the course of a Candida albicans septicaemia. In 12 patients with renal transplants it was possible, by treatment with nystatin, clotrimazole, flucytosine, miconazole and amphotericine B to control a generalized or clinically manifest Candida albicans infection. Three died of the septicaemia or meningoencephalitis, six as the result of bacterial superinfections. Inspection of the mouth is an important means of early diagnosing fungal infections. Antimycotic treatment should be started if fungal cultures from urine are repeatedly positive even if the clinical findings are still negative.

Topics: Adult; Amphotericin B; Candidiasis; Candidiasis, Oral; Candidiasis, Vulvovaginal; Child; Cholestasis; Clotrimazole; Female; Humans; Kidney Transplantation; Male; Meningoencephalitis; Miconazole; Middle Aged; Nystatin; Postoperative Complications; Sepsis; Transplantation, Homologous

The mechanical and physical effects of the presence of nystatin in three denture liners were investigated. In general, the modified materials were softer, showed greater strain, and demonstrated permanent set under compression for the duration of the tests. However, the degree of change in properties appeared unlikely to lead to reduced clinical performance. The most significant change was a great increase in the equilibrium capacity for water in the case of the modified liners. This may enhance the pharmacologic effectiveness of these liners by encouraging the release of nystatin at the tissue surface. Bacteriologic and clinical studies continue to investigate the possibility that modified semipermanent liners (Coe-Supersoft) may reduce the recurrence of denture stomatitis.

Topics: Absorption; Candidiasis, Oral; Chemical Phenomena; Chemistry; Denture Bases; Denture Design; Denture Liners; Hardness; Humans; Nystatin; Recurrence; Stress, Mechanical; Water

Topics: Amphotericin B; Antifungal Agents; Candida; Candidiasis, Cutaneous; Candidiasis, Oral; Child; Chronic Disease; Dose-Response Relationship, Drug; Drug Resistance, Microbial; Female; Flucytosine; Fluorouracil; Humans; Hypersensitivity, Delayed; Immunologic Deficiency Syndromes; Immunotherapy; Lymphocyte Activation; Microbial Sensitivity Tests; Nystatin; Skin Diseases; Staphylococcal Infections

Topics: Anti-Bacterial Agents; Candidiasis, Oral; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Nystatin; Pregnancy; Puerperal Disorders

Topics: Adult; Aged; Candidiasis, Oral; Denture, Complete; Female; Humans; Middle Aged; Mouth Diseases; Mycoses; Nystatin; Stomatitis, Denture

Topics: Candida albicans; Candidiasis, Oral; Humans; Mitosporic Fungi; Mouth Mucosa; Mouth Rehabilitation; Nystatin

Topics: Candida albicans; Candidiasis, Oral; Nystatin; Stomatitis, Denture

Topics: Amphotericin B; Antifungal Agents; Balanitis; Candida albicans; Candidiasis, Cutaneous; Candidiasis, Oral; Candidiasis, Vulvovaginal; Coloring Agents; Contraceptives, Oral; Diabetes Complications; Female; Humans; Infant, Newborn; Male; Nails; Nystatin; Paronychia; Pregnancy; Pregnancy Complications, Infectious; Saccharomyces

Topics: Amphotericin B; Antifungal Agents; Candida albicans; Candidiasis; Candidiasis, Oral; Diaper Rash; Drug Resistance, Microbial; Female; Griseofulvin; Humans; Male; Mouth Diseases; Nystatin; Ointments; Paronychia; Pruritus Ani; Skin Diseases; Tinea; Tinea Pedis; Tinea Versicolor

Topics: Candida; Candidiasis, Oral; Denture Liners; Humans; Nystatin; Stomatitis; Stomatitis, Denture

Topics: Amphotericin B; Biopsy; Candida albicans; Candidiasis, Oral; Cheilitis; Diabetes Complications; Endocrine System Diseases; Fluorescent Antibody Technique; Humans; Immunity, Cellular; Immunologic Deficiency Syndromes; Leukoplakia, Oral; Metabolic Diseases; Nutrition Disorders; Nystatin; Sjogren's Syndrome; Stomatitis, Denture

Topics: Amphotericin B; Candidiasis, Cutaneous; Candidiasis, Oral; Candidiasis, Vulvovaginal; Contraceptive Agents; Female; Granuloma; Humans; Infant, Newborn; Infant, Newborn, Diseases; Natamycin; Nystatin; Pregnancy

Topics: Amphotericin B; Candida albicans; Candidiasis; Candidiasis, Oral; Central Nervous System Diseases; Culture Media; Digestive System; Female; Gastroenteritis; Gentian Violet; Humans; Infant, Newborn; Mustard Compounds; Nystatin; Urinary Tract Infections

Topics: Amphotericin B; Candida; Candidiasis, Oral; Dentures; Humans; Nystatin

Topics: Candidiasis, Oral; Dentures; Humans; Nystatin

Topics: Amphotericin B; Candidiasis, Oral; Dentures; Humans; Nystatin; Stomatitis

Topics: Amphotericin B; Candidiasis, Oral; Female; Humans; Male; Nystatin

Topics: Candidiasis, Cutaneous; Candidiasis, Oral; Child; Female; Fingers; Granuloma; Humans; Nystatin; Scalp Dermatoses

Topics: Adult; Amphotericin B; Candidiasis; Candidiasis, Oral; Esophageal Diseases; Fluoroscopy; Humans; Leukemia; Leukemia, Myeloid; Male; Middle Aged; Nystatin

Topics: Candidiasis, Oral; Cheilitis; Denture, Complete; Neomycin; Nystatin

Topics: Adult; Aged; Burning Mouth Syndrome; Candidiasis, Oral; Dental Occlusion, Balanced; Denture, Complete; Female; Humans; Male; Middle Aged; Nystatin; Stomatitis; Tissue Conditioning, Dental

Topics: Balanitis; Candidiasis; Candidiasis, Cutaneous; Candidiasis, Oral; Candidiasis, Vulvovaginal; Female; Humans; Male; Natamycin; Nystatin; Ointments; Paronychia; Powders; Quinolines; Suspensions

Topics: Acrylic Resins; Adult; Aged; Anti-Bacterial Agents; Candidiasis, Oral; Chromium Alloys; Cytodiagnosis; Denture, Complete; Denture, Partial, Removable; Drug Resistance, Microbial; Female; Humans; Hypersensitivity; Male; Middle Aged; Nystatin; Palate; Stomatitis; Tissue Conditioning, Dental

Topics: Candidiasis, Oral; Female; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature, Diseases; Nystatin; Pregnancy

Topics: Addison Disease; Adolescent; Candida; Candidiasis; Candidiasis, Cutaneous; Candidiasis, Oral; Female; Humans; Nystatin

Topics: Amphotericin B; Anti-Infective Agents, Local; Burns; Candidiasis, Oral; Denture, Complete; Humans; Nystatin; Oral Health

Topics: Acute Disease; Adult; Aged; Candidiasis, Oral; Chronic Disease; Female; Gentian Violet; Humans; Male; Middle Aged; Nystatin; Retrospective Studies

Topics: Adult; Amphotericin B; Antifungal Agents; Candidiasis, Oral; Humans; Male; Nystatin

Topics: Adolescent; Amphotericin B; Candidiasis, Cutaneous; Candidiasis, Oral; Drug Resistance, Microbial; Female; Humans; Lung Diseases; Middle Aged; Nystatin; Oral Manifestations; Sarcoidosis

Topics: Actinomycosis; Candidiasis, Oral; Female; Genital Diseases, Female; Humans; Intrauterine Devices; Leiomyoma; Middle Aged; Nystatin; Penicillins; Pregnancy; Sulfisoxazole; Uterine Neoplasms

Topics: Antifungal Agents; Candidiasis, Oral; Gentian Violet; Humans; Infant, Newborn; Infant, Newborn, Diseases; Nystatin

Topics: Brain Abscess; Brain Diseases; Candidiasis; Candidiasis, Oral; Female; Granuloma; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Lung Diseases, Fungal; Male; Nystatin

Topics: Candidiasis, Oral; Dentistry; Nystatin; Stomatitis

Topics: Aged; Candida; Candidiasis, Oral; Cheilitis; Denture Bases; Denture Retention; Denture, Complete, Upper; Female; Humans; Inflammation; Male; Middle Aged; Mouth; Mouth Mucosa; Nystatin; Oral Health; Saliva; Stomatitis; Vertical Dimension; Vitamin B Deficiency

Topics: Candidiasis, Oral; Denture, Complete; Female; Humans; Impetigo; Middle Aged; Mouth Diseases; Nystatin; Skin Diseases

Topics: Candidiasis, Oral; Dentistry; Nystatin

Topics: Animals; Anti-Bacterial Agents; Antifungal Agents; Candida; Candidiasis, Oral; Gentian Violet; Humans; In Vitro Techniques; Mice; Mouthwashes; Nystatin; Sulfonamides; Tongue Diseases

Topics: Balanitis; Candidiasis, Cutaneous; Candidiasis, Oral; Candidiasis, Vulvovaginal; Dermatitis; Diabetes Complications; Drug Hypersensitivity; Female; Humans; Infant; Male; Middle Aged; Neomycin; Nystatin; Pregnancy; Pregnancy Complications, Infectious

Topics: Achlorhydria; Anemia; Candidiasis; Candidiasis, Oral; Cheilitis; Deglutition Disorders; Drug Therapy; Geriatrics; Humans; Nystatin; Plummer-Vinson Syndrome; Postgastrectomy Syndromes; Tongue Diseases

Topics: Biomedical Research; Candida; Candidiasis; Candidiasis, Oral; Drug Therapy; Geriatrics; Humans; Leukoplakia; Leukoplakia, Oral; Mouth Diseases; Mycoses; Nystatin; Pathology; Yeasts

Topics: Candidiasis; Candidiasis, Oral; Cheilitis; Denture, Complete; Dentures; Drug Therapy; Glossitis; Humans; Nystatin; Stomatitis

Topics: Adolescent; Adult; Anti-Bacterial Agents; Candidiasis, Oral; Candidiasis, Vulvovaginal; Female; Humans; Male; Metronidazole; Middle Aged; Nystatin; Trichomonas Vaginitis

Topics: Bacteriological Techniques; Candidiasis; Candidiasis, Cutaneous; Candidiasis, Oral; Dermatitis, Exfoliative; Diagnosis, Differential; Drug Eruptions; Female; Fetal Diseases; Fludrocortisone; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Neomycin; Nystatin; Paronychia; Pathology; Pregnancy; Pregnancy Complications, Infectious

Topics: Anti-Bacterial Agents; Candidiasis; Candidiasis, Oral; Deglutition Disorders; Diagnosis; Esophagitis; Humans; Nystatin; Pneumonia; Prednisolone; Radiography; Sulfonamides; Tetracycline

Topics: Candidiasis, Oral; Candidiasis, Vulvovaginal; Child; Cross Infection; Female; History; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Nystatin; Pregnancy; Pregnancy Complications; Statistics as Topic

Topics: Adrenal Cortex Hormones; Anti-Bacterial Agents; Antibiotics, Antitubercular; Antineoplastic Agents; Atrophy; Biomedical Research; Candidiasis; Candidiasis, Oral; Drug Therapy; Geriatrics; Halitosis; Nystatin; Pathology; Toxicology

Topics: Amphotericin B; Antidepressive Agents; Candidiasis, Oral; Candidiasis, Vulvovaginal; Drug Therapy; Mental Disorders; Nystatin; Oral Manifestations; Toxicology; Tranquilizing Agents; Xerostomia

Topics: Antineoplastic Agents; Candidiasis; Candidiasis, Oral; Dermatologic Agents; Glycerol; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Nystatin; Peroxides; Urea

Topics: Candida albicans; Candidiasis; Candidiasis, Oral; Deglutition Disorders; Esophagitis; Esophagoscopy; Humans; Lung Neoplasms; Nystatin; Oxytetracycline; Penicillins; Speech Disorders; Vocal Cord Paralysis

Topics: Addison Disease; Administration, Cutaneous; Adrenal Insufficiency; Amphotericin B; Candidiasis; Candidiasis, Cutaneous; Candidiasis, Oral; Gentian Violet; Humans; Hypoadrenocorticism, Familial; Hypoparathyroidism; Nystatin; Sweden

Topics: Adrenal Cortex Hormones; Asthma; Candidiasis; Candidiasis, Oral; Humans; Nystatin; Toxicology; Triamcinolone

Topics: Administration, Cutaneous; Adolescent; Amphotericin B; Candidiasis, Cutaneous; Candidiasis, Oral; Candidiasis, Vulvovaginal; Child; Female; Humans; Infant; Infant, Newborn; Nystatin

Topics: Borates; Candida; Candidiasis; Candidiasis, Oral; Fungi; Gastroenterology; Gentian Violet; Humans; Infant; Infant, Newborn; Infant, Premature, Diseases; Lung Diseases; Lung Diseases, Fungal; Methylene Blue; Nystatin; Pharmacology; Respiratory Tract Infections

Topics: Administration, Cutaneous; Candidiasis, Cutaneous; Candidiasis, Oral; Chloroquine; Facial Paralysis; Hair; Hair Follicle; Humans; Melkersson-Rosenthal Syndrome; Nystatin

Topics: Anti-Bacterial Agents; Antibiotics, Antitubercular; Candidiasis; Candidiasis, Oral; Dermatologic Agents; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Nurseries, Hospital; Nystatin

Topics: Anti-Bacterial Agents; Antibiotics, Antitubercular; Candidiasis, Oral; Dermatologic Agents; Humans; Infant, Newborn; Infant, Newborn, Diseases; Nystatin; Skin Diseases

Topics: Anti-Bacterial Agents; Antibiotics, Antitubercular; Candidiasis, Oral; Dermatologic Agents; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Nystatin; Skin Diseases

Topics: Anti-Bacterial Agents; Antifungal Agents; Candidiasis, Oral; Child; Dermatologic Agents; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Nystatin; Pneumonia; Skin Diseases