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Updated: May 24, 2026
Examination of Oral Candida Infection in Primary Sjögren's Syndrome Patients
Published on: March 1, 2024
Candidiasis (oropharyngeal)
1King's College London at Guy's, King's and St Thomas's Dental Institute, London, UK.
Introduction:
Candida is a fungus present in the mouths of up to 60% of healthy people, but overt infection is associated with immunosuppression, diabetes, broad-spectrum antibiotics, and corticosteroid use. In most people, untreated candidiasis persists for months or years unless associated risk factors are treated or eliminated. In neonates, spontaneous cure of oropharyngeal candidiasis usually occurs after 3 to 8 weeks.
Methods And Outcomes:
We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of interventions to prevent and treat oropharyngeal candidiasis in: adults having treatment causing immunosuppression; infants and children; people with diabetes; people with dentures; and people with HIV infection? Which treatments reduce the risk of acquiring resistance to antifungal drugs? We searched: Medline, Embase, The Cochrane Library, and other important databases up to August 2011 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
Results:
We found 51 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
Conclusions:
In this systematic review we present information relating to the effectiveness and safety of the following interventions: antifungals (absorbed or partially absorbed, and topical absorbed/partially absorbed/non-absorbed: e.g., amphotericin B, clotrimazole, fluconazole, itraconazole, ketoconazole, miconazole, nystatin, posaconazole) used for intermittent or continuous prophylaxis or treatment, and denture hygiene.
Insights
This systematic review examines interventions for oropharyngeal candidiasis, a common fungal infection. It evaluates antifungals and denture hygiene for prevention and treatment across various patient groups.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Evidence-Based Medicine
Background:
- Oropharyngeal candidiasis is a common fungal infection, often asymptomatic but can become overt in immunocompromised individuals, diabetics, or those on certain medications.
- Untreated oral candidiasis can persist for extended periods, with spontaneous resolution in neonates typically occurring within 3-8 weeks.
- Risk factors for candidiasis include immunosuppression, diabetes, broad-spectrum antibiotics, and corticosteroid use.
Purpose of the Study:
- To systematically review the effectiveness and safety of interventions for preventing and treating oropharyngeal candidiasis.
- To address specific clinical questions regarding interventions in adults with treatment-induced immunosuppression, infants, children, people with diabetes, denture wearers, and individuals with HIV.
- To identify treatments that minimize the risk of developing antifungal resistance.
Main Methods:
- A systematic review of 51 relevant studies, including systematic reviews, randomized controlled trials (RCTs), and observational studies.
- Searches conducted across major databases (Medline, Embase, Cochrane Library) up to August 2011.
- Inclusion of harms alerts from regulatory agencies like the US FDA and UK MHRA.
Main Results:
- The review identified 51 studies meeting inclusion criteria, encompassing various interventions for oropharyngeal candidiasis.
- A GRADE evaluation was performed to assess the quality of evidence for the included interventions.
- Data on the effectiveness and safety of antifungals and denture hygiene were compiled.
Conclusions:
- The systematic review provides information on the effectiveness and safety of various antifungal agents (e.g., amphotericin B, clotrimazole, fluconazole, nystatin) for oropharyngeal candidiasis.
- Interventions evaluated include absorbed, partially absorbed, and non-absorbed antifungals for prophylaxis and treatment.
- Denture hygiene is also considered as an intervention in the management of oropharyngeal candidiasis.
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