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Nystatin Effectiveness in Oral Candidiasis Treatment: A Systematic Review & Meta-Analysis of Clinical Trials
Anamika Rai1, Satya Ranjan Misra1, Saurav Panda2
1Department of Oral Medicine & Radiology, Institute of Dental Sciences, Siksha 'O' Anusandhan University, Bhubaneswar 751003, India.
Abstract:
Oral candidiasis is the most common opportunistic fungal infection caused by commensal Candida species. Since there are various local and systemic predisposing factors for the disease, the treatment also varies from topical to systemic antifungal agents. Nystatin is a common antifungal agent used topically. The aim of this systematic review was to evaluate and compare the efficacy of different antifungal agents and the safety of nystatin in the treatment of oral candidiasis. Three electronic databases were searched for randomized controlled trials comparing nystatin with other anti-fungal therapies or placebo. Clinical and/or mycological cure was the outcome evaluation. A meta-analysis and descriptive study on the efficacy, treatment protocols, and safety of nystatin was also conducted. The meta-analysis included five studies, which compared the efficacy of nystatin suspensions with photodynamic therapy. A significant difference in the colony-forming units per milliliters (CFU/mL) of Candida species was observed at 60 days intervals for both palatal mucosa and denture surfaces, with both groups favoring nystatin with low heterogeneity at a 95% confidence interval. Nystatin and photodynamic therapy were found to be equally effective for the clinical remission of denture stomatitis as well as a significant reduction of CFU/mL of Candida species from dentures and palatal surfaces of the patients.
Insights
Nystatin and photodynamic therapy show equal effectiveness in treating oral candidiasis, reducing Candida species. This systematic review compared antifungal treatments for this common opportunistic infection.
Area of Science:
- Oral Medicine
- Mycology
- Pharmacology
Background:
- Oral candidiasis is a common opportunistic fungal infection caused by Candida species.
- Treatment varies based on predisposing factors, with topical and systemic antifungal agents used.
- Nystatin is a frequently used topical antifungal agent.
Purpose of the Study:
- To evaluate and compare the efficacy of different antifungal agents for oral candidiasis.
- To assess the safety of nystatin in treating oral candidiasis.
- To compare nystatin with photodynamic therapy for oral candidiasis.
Main Methods:
- Systematic review of randomized controlled trials from three electronic databases.
- Comparison of nystatin with other antifungal therapies or placebo.
- Meta-analysis of five studies comparing nystatin suspensions with photodynamic therapy.
Main Results:
- Both nystatin and photodynamic therapy demonstrated equal efficacy in the clinical remission of denture stomatitis.
- A significant reduction in Candida species colony-forming units per milliliter (CFU/mL) was observed on palatal mucosa and denture surfaces.
- Low heterogeneity was noted, favoring nystatin with a 95% confidence interval.
Conclusions:
- Nystatin and photodynamic therapy are equally effective in treating oral candidiasis, specifically denture stomatitis.
- Both treatments significantly reduce Candida species load from oral surfaces and dentures.
- Nystatin remains a safe and effective topical agent for oral candidiasis.
