Aloe vera Adjunctive Therapy for Pediatric Oral Candidiasis: A Prospective Controlled Study on Microbial Clearance...

Oral candidiasis is frequently encountered in pediatric populations, particularly in infants and toddlers, where the development of immunity and inconsistent oral hygiene contribute to disease susceptibility. While topical antifungal agents remain the standard of care, treatment challenges persist, especially regarding adherence and recurrence. Aloe vera, recognized for its antimicrobial, anti-inflammatory, and mucosal healing properties, may offer therapeutic benefits when used in conjunction with standard regimens. This study aimed to evaluate the adjunctive effect of topical Aloe vera gel, when added to standard antifungal therapy, on reducing fungal load and improving treatment adherence in children with moderate oral candidiasis.

A prospective controlled study was conducted among 54 children diagnosed with moderate oral candidiasis. Participants were randomly assigned to receive either standard topical nystatin or nystatin in conjunction with Aloe vera gel over a 7 day treatment duration. Fungal load was assessed using colony-forming units (CFU) counts from oral swabs collected at baseline and day 7, analyzed via ANCOVA. Additional parameters included treatment adherence, compared using an independent t-test, and clinical recurrence at a 14-day post-treatment follow-up, assessed through logistic regression.

Baseline characteristics were similar across groups. By day 7, children in the Aloe vera group exhibited a greater reduction in fungal load compared to those receiving standard therapy alone. Adherence was significantly higher in the aloe group (92.73% vs. 89.21%; p < 0.0001). Regression analysis identified both baseline fungal burden and adherence as factors associated with an increased risk of recurrence.

The addition of Aloe vera gel to standard therapy may support a more effective fungal clearance and improved treatment adherence in children with moderate oral candidiasis, suggesting its potential as a complementary treatment option. Given the single-center design, short follow-up, and underpowered recurrence analysis, these findings should be considered preliminary, pending confirmation in larger studies with symptom-anchored endpoints.