A randomized clinical trial of chlorhexidine in the maintenance of oral candidiasis‐free period in HIV infection

Abstract

OBJECTIVE-To determine if chlorhexidine can be used as an intervention to prolong the time to relapse of oral candidiasis.SUBJECTS AND METHODS-A double-blinded randomized clinical trial was performed in 75 HIV/AIDS subjects with oral candidiasis. Clotrimazole troche was prescribed, and the subjects were re-examined every 2 weeks until the lesions were completely eradicated. The subjects were then randomly divided into two groups; 0.12% chlorhexidine (n = 37, aged 22-52 years, mean 34 years) and 0.9% normal saline (n = 38, aged 22-55 years, mean 38 years). They were re-examined every 2 weeks until the next episode was observed.RESULTS-The time to recurrence of oral candidiasis between the chlorhexidine and the saline group was not statistically significant (P > 0.05). The following variables were significantly associated with the time of recurrence; frequency of antifungal therapy (P = 0.011), total lymphocyte (P = 0.017), alcohol consumption (P = 0.043), and candidiasis on gingiva (P = 0.048). The subjects with lower lymphocyte showed shorter oral candidiasis-free periods (P = 0.034).CONCLUSIONS-Chlorhexidine showed a small but not statistically significant effect in maintenance of oral candidiasis-free period. This lack of significance may be due to the small sample size. Further study should be performed to better assess the size of the effect, or to confirm our findings.

Current strategies for prevention of oral manifestations of human immunodeficiency virus

“…A study of 0.12% chlorhexidine mouthrinse showed a small, but not statistically significant, effect in maintenance of an OC-free period in HIV-infected adults in one double-blind randomized clinical trial. 28 A pilot study in children with HIV suggested that daily topical disinfection with chlorhexidine has potential for reduction in candidal colonization and subsequent infection with OC. 29 The use of a 0.025% lawsone methyl ether mouthwash in a small comparison trial to 0.2% chlorhexidine mouthwash for 2 weeks in HIV-infected and denture-wearing patients in Thailand demonstrated comparable lack of development of drug resistance and no significant changes in genotype.…”

Therapy and prophylaxis of opportunistic infections in HIV-infected patients: a guideline by the German and Austrian AIDS societies (DAIG/ÖAG) (AWMF 055/066)

“…OC in HIV-infected children and adults can be treated and relapses prevented by applying disinfecting mouth rinses containing chlorhexidine 0.12 % 1–2× daily for a 90-day period [127, 128]. In the pre-HAART era, secondary prophylaxis or life-long therapy with fluconazole led to significant reductions of chronic recurring oropharyngeal candidiasis—but it has also led to the development of secondary resistance [129, 130].…”

Oral health promotion interventions on oral yeast in hospitalised and medically compromised patients: a systematic review

“…failed to observe reductions in yeast prevalence following 0.12% chlorhexidine mouthrinse use and provision of oral hygiene instructions. In a RCT, 35 Nittayananta et al. observed a small but insignificant delay in time to relapse of candidiasis in HIV‐positive patients (previously cured of candidiasis with clotrimazole) using a 0.12% chlorhexidine mouthrinse as opposed to a 0.9% saline mouthrinse.…”