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Oropharyngeal Candidiasis: A review of Current Intervention Strategies

Published online by Cambridge University Press:  22 June 2006

Caroline Emery
Affiliation:
Healthy Visitor and Teaching Led Lecture University of Southampton, Southampton, UK

Extract

Summary This article sets out to review recent research studies pertaining to the drug treatment of oropharyngeal candidiasis in infants. The main aims of treatment programmes are to resolve signs and symptoms of the infection; and minimise drug induced resistance, with minimal adverse side effects. A search for clinical evidence using Medline, Nursing Index and Embase between 1995 and 2003, produces no systemic reviews, no placebo controlled trials only three random control trials for the treatment of oropharyngeal candidiasis in infants. Three independent randomised control trials with samples of infants with oropharyngeal candidiasis (who were not immuno-compromised), compare the three main drug treatments of choice for infants, i.e. miconazole gel, clotrimazole (nystatin) suspension, and fluconazole suspension. The randomised trial of these infants found that miconazole gel had a significantly higher cure rate compared with nystatin suspension. At day 12 of the trial there was a 99% cure rate with the use of miconazole gel (25 mg QDS) compared to only a cure rate of 54% with nystatin suspension (100 000 IU QDS) (P> < 0.0001). The evidence from these studies suggest that miconazole gel (25 mg QDS) is the drug of choice for health visitors treating infants with oropharangeal candidiasis, as it is a safe and effective and cost effective treatment regime from birth.

Type
Focus On
Copyright
© 2006 Cambridge University Press

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References

British Medical Association and the Royal Pharmaceutical Society of Great Britain. NPF incorporating BNF 46. Pharmaceutical Press (2003).
Ellepola AN, Samaranayake LP. Antimycotic agents in oral candidosis: an overview: 1. Clinical variants. Dent Update 2000 Apr; 27(3): 1112, 1146. Review.Google Scholar
Webb BC, Thomas CJ, Willcox MD, Harty DW, Knox KW. Candida-associated denture stomatitis. Aetiology and management: a review. Part 3. Treatment of oral candidosis. Aust Dent J. 1998 Aug; 43(4): 2449. Review.Google Scholar
Hoppe JE, Hahn H. Randomized comparison of two nystatin oral gels with miconazole oral gel for treatment of oral thrush in infants. Antimycotics Study Group. Infection 1996 Mar–Apr; 24(2): 1369.Google Scholar
Hoppe JE. Treatment of oropharyngeal candidiasis in immunocompetent infants: a randomised multicenter study of miconazole gel vs. nystatin suspension. The Antifungals Study Group. Pediatr Infect Dis J 1997 Mar; 16(3): 28893.Google Scholar
Goins RA, Ascher D, Waecker N, Arnold J, Moorefield E. Comparison of fluconazole and nystatin oral suspensions for treatment of oral candidiasis in infants. Pediatr Infect Dis J 2002 Dec; 21(12): 11657.Google Scholar