Efficacy of nystatin for the treatment of oral candidiasis: a systematic review and meta-analysis
Xin Lyu, Chen Zhao, Zhi-min Yan, Hong HuaDepartment of Oral Medicine, Peking University School and Hospital of Stomatology, Beijing, People’s Republic of ChinaObjective: To systematically review and assess the efficacy, different treatment protocols (formulation, dosage, and duration), and...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2016-03-01
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| Series: | Drug Design, Development and Therapy |
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| Online Access: | https://www.dovepress.com/efficacy-of-nystatin-for-the-treatment-of-oral-candidiasis-a-systemati-peer-reviewed-article-DDDT |
| _version_ | 1811240582967721984 |
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| author | Lyu X Zhao C Yan ZM Hua H |
| author_facet | Lyu X Zhao C Yan ZM Hua H |
| author_sort | Lyu X |
| collection | DOAJ |
| description | Xin Lyu, Chen Zhao, Zhi-min Yan, Hong HuaDepartment of Oral Medicine, Peking University School and Hospital of Stomatology, Beijing, People’s Republic of ChinaObjective: 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: nystatin, oral candidiasis, systematic review, meta-analysis, safety, dosage forms, treatment duration |
| first_indexed | 2024-04-12T13:22:47Z |
| format | Article |
| id | doaj.art-3c9f6b1f110944978ae22b7cb3038eed |
| institution | Directory Open Access Journal |
| issn | 1177-8881 |
| language | English |
| last_indexed | 2024-04-12T13:22:47Z |
| publishDate | 2016-03-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Drug Design, Development and Therapy |
| spelling | doaj.art-3c9f6b1f110944978ae22b7cb3038eed2022-12-22T03:31:25ZengDove Medical PressDrug Design, Development and Therapy1177-88812016-03-012016Issue 11161117126024Efficacy of nystatin for the treatment of oral candidiasis: a systematic review and meta-analysisLyu XZhao CYan ZMHua HXin Lyu, Chen Zhao, Zhi-min Yan, Hong HuaDepartment of Oral Medicine, Peking University School and Hospital of Stomatology, Beijing, People’s Republic of ChinaObjective: 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: nystatin, oral candidiasis, systematic review, meta-analysis, safety, dosage forms, treatment durationhttps://www.dovepress.com/efficacy-of-nystatin-for-the-treatment-of-oral-candidiasis-a-systemati-peer-reviewed-article-DDDTnystatinoral candidiasissystematic reviewmeta-analysis |
| spellingShingle | Lyu X Zhao C Yan ZM Hua H Efficacy of nystatin for the treatment of oral candidiasis: a systematic review and meta-analysis Drug Design, Development and Therapy nystatin oral candidiasis systematic review meta-analysis |
| title | Efficacy of nystatin for the treatment of oral candidiasis: a systematic review and meta-analysis |
| title_full | Efficacy of nystatin for the treatment of oral candidiasis: a systematic review and meta-analysis |
| title_fullStr | Efficacy of nystatin for the treatment of oral candidiasis: a systematic review and meta-analysis |
| title_full_unstemmed | Efficacy of nystatin for the treatment of oral candidiasis: a systematic review and meta-analysis |
| title_short | Efficacy of nystatin for the treatment of oral candidiasis: a systematic review and meta-analysis |
| title_sort | efficacy of nystatin for the treatment of oral candidiasis a systematic review and meta analysis |
| topic | nystatin oral candidiasis systematic review meta-analysis |
| url | https://www.dovepress.com/efficacy-of-nystatin-for-the-treatment-of-oral-candidiasis-a-systemati-peer-reviewed-article-DDDT |
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