Efficacy of nystatin for the treatment of oral candidiasis: a systematic review and meta-analysis

Abstract

ObjectiveTo systematically review and assess the efficacy, different treatment protocols (formulation, dosage, and duration), and safety of nystatin for treating oral candidiasis.MethodsFour 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.ResultsThe 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.ConclusionNystatin 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.

Randomized pilot study on probiotic effects on recurrent candidiasis in oral lichen planus patients

“…Initially, all patients were treated with the current conventional treatment regimens at the Clinic for Oral Medicine, including those who required additional conventional treatment during the 1‐year study period. Patients diagnosed with OC were treated with Nystatin 100.000 IE/ml sugar‐free oral mixture 1 ml, four times daily for 24 days, which is the standard topical treatment duration at the department and is in agreement with the antimycotic guidelines of other recent studies (Lyu, Zhao, Yan, & Hua, ; Rautemaa & Ramage, ). Patients with symptoms without OC were treated with steroid, fluocinolone acetonide gel 0.025% for 3 weeks (three times daily the first week, twice daily the next week, and once daily the last week).…”

Physical and Mechanical Properties of Antifungal Ionic Liquid-Incorporated Dental Tissue Conditioner

“…The first choice of denture stomatitis treatment is to remove denture in order that oral tissue can recover into normal condition, along with antifungal drug prescription if the sign of fungal infection is presented [6] [7]. However, removing denture may cause masticatory problem and esthetic concern to the patient.…”

Assessment of effectiveness of fluconazole and clotrimazole in treating oral candidiasis patients: A comparative study

“…[1] There occurrence has been widely described in the literature. Over the last four to five decades, the frequency and incidence of occurrence of candidiasis has significantly increased.…”