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Review
. 2016 Mar 16:10:1161-71.
doi: 10.2147/DDDT.S100795. eCollection 2016.

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

Xin Lyu  1 , Chen Zhao  1 , Zhi-Min Yan  1 , Hong Hua  1
Affiliations
Review

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

Xin Lyu et al. Drug Des Devel Ther. .

Abstract

Objective: To systematically review and assess the efficacy, different treatment protocols (formulation, dosage, and duration), and safety of nystatin for treating oral candidiasis.

Methods: Four 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.

Results: The 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.

Conclusion: Nystatin 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.

Keywords: dosage forms; meta-analysis; nystatin; oral candidiasis; safety; systematic review; treatment duration.

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Figures

Figure 1
Figure 1
Trial flow and study selection. Abbreviation: SCI, Science Citation Index.
Figure 2
Figure 2
Risk of bias graph: the overall risk of each bias is presented as a percentage representing the risk in all the included studies.
Figure 3
Figure 3
Risk of bias summary: the risk of each bias in each of the included studies is shown separately. Note: +, ?, − indicate the low bias, uncertain, and high bias, respectively.
Figure 4
Figure 4
Forest plots evaluating the efficacy of nystatin (fixed-effect model). Notes: (A) The overall clinical efficacy of nystatin was significantly superior to the placebo in treating denture stomatitis; (B) the overall mycological efficacy of nystatin was significantly superior to the placebo in treating denture stomatitis; (C) the overall clinical efficacy of nystatin was significantly inferior to fluconazole for treating oral or oropharyngeal candidiasis in infants, children, and HIV/AIDS patients; and (D) the overall mycological efficacy of nystatin was significantly inferior to fluconazole for treating oral or oropharyngeal candidiasis in infants, children, and HIV/AIDS patients. Abbreviations: CI, confidence interval; OR, odds ratio.
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References

    1. Melkoumov A, Goupil M, Louhichi F, Raymond M, de Repentigny L, Leclair G. Nystatin nanosizing enhances in vitro and in vivo antifungal activity against Candida albicans. J Antimicrob Chemother. 2013;68(9):2099–2105. - PubMed
    1. Akpan A, Morgan R. Oral candidiasis. Postgrad Med J. 2002;78(922):455–459. - PMC - PubMed
    1. Epstein JB, Polsky B. Oropharyngeal candidiasis: a review of its clinical spectrum and current therapies. Clin Ther. 1998;20(1):40–57. - PubMed
    1. Coronado-Castellote L, Jimenez-Soriano Y. Clinical and microbiological diagnosis of oral candidiasis. J Clin Exp Dent. 2013;5(5):e279–e286. - PMC - PubMed
    1. Samaranayake LP, Keung Leung W, Jin L. Oral mucosal fungal infections. Periodontol 2000. 2009;49:39–59. - PubMed

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