A pseudo-randomised clinical trial of in situ gels of fluconazole for the treatment of oropharngeal candidiasis

Nairy, Harish M; Charyulu, Narayana; Shetty, Veena; Prabhakara, P. RajaReddy K.

doi:10.1186/1745-6215-12-99

Cited by 12 publications

(9 citation statements)

References 9 publications

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“…cultures from swabs taken at the same sites used before treatment. 11 For the first approach, the evaluation was rated as better (minimal signs and symptoms with no residual visible candidiasis), unchanged, and worse. Following the initial visit, patients were clinically examined every 2 days.…”

Section: Methodsmentioning

confidence: 99%

Antimicrobial Photodynamic Therapy in the Treatment of Oral Candidiasis in HIV-Infected Patients

Scwingel

Barcessat

Núñez³

et al. 2012

Photomedicine and Laser Surgery

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Objective: Antimicrobial photodynamic therapy (aPDT) has been used to combat local infections, and it consists of the combination of a photosensitizer, a light source, and reactive oxygen species (ROS) to kill microbial cells. In this study, we evaluated the effectiveness of aPDT in the treatment of candidiasis in HIV-infected patients. Methods: Twenty-one patients were divided into three groups. Control group (CG) was treated with the conventional medication for candidiasis (fluconazole 100 mg/day during 14 days). Laser group (LG) was subjected to low-level laser therapy (LLLT), wavelength 660 nm, power of 30 mW, and fluence of 7.5 J/cm 2 , in contact with mucosa during 10 sec on the affected point. An aPDT group (aPDTG) was treated with aPDT, that is, combination of a low-power laser and methylene blue 450 lg/mL. Pre-irradiation time was 1 min. Parameters of irradiation were the same ones as for the LG, and patients were single irradiated. Patients were clinically evaluated and culture analysis was performed before, immediately after, and 7, 15, and 30 days after the treatment. Results: Our results showed that fluconazole was effective; however, it did not prevent the return of the candidiasis in short-term. LLLT per se did not show any reduction on Candida spp. aPDT eradicated 100% of the colonies of this fungus and the patients did not show recurrence of candidiasis up to 30 days after the irradiation. Conclusions: These findings suggest that aPDT is a potential approach to oral candidiasis treatment in HIV-infected patients.

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Section: Methodsmentioning

confidence: 99%

Antimicrobial Photodynamic Therapy in the Treatment of Oral Candidiasis in HIV-Infected Patients

Scwingel

Barcessat

Núñez³

et al. 2012

Photomedicine and Laser Surgery

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“…A single-dose regimen of 750 mg fluconazole has been shown to be as effective as a standard 14-day regimen (Hamza et al, 2008). In addition, in situ fluconazole gel demonstrated effectiveness compared to daily 100 mg fluconazole tablets (Nairy et al, 2011). However, prolonged use of fluconazole increases the risk of developing azole-resistant C. albicans (Patton et al, 2001).…”

Section: Antifungal Drug Resistancementioning

confidence: 99%

Oral fungi inHIV: challenges in antifungal therapies

Nittayananta

2016

Oral Diseases

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Oral candidiasis (OC) caused by Candida species is a common fungal infection among HIV‐infected individuals. Despite the wide use of antiretroviral therapy (ART) resulting in a declined prevalence, OC remains the most common oral lesions seen in those living with HIV/AIDS. Various topical and systemic antifungal drugs are available to treat OC. However, due to the patients’ immunodeficiency and the nature of OC as biofilm‐associated infection, relapse is frequently observed after cessation of antifungal therapy. In addition, long‐term antifungal therapy may lead to drug resistance. This review article addressed three major challenges in the treatment of OC in HIV infection including antifungal drug resistance, biofilm‐associated infection of OC, and the host underlying immunodeficiency. To reduce the risks of antifungal drug resistance, the author recommends that future studies should focus on herbal plant‐derived compounds with antifungal activity that may be used in combination with the drugs. Also, it is recommended that more research should be carried out to explore how to enhance the host innate immunity against oral Candida.

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“…Recently, a single‐dose regimen of 750 mg fluconazole has been shown to be as effective as a standard 14‐day regimen in achieving clinical and mycological cure in the treatment for OC in patients with HIV infection (Hamza et al , ). A small trial of in situ fluconazole gel demonstrated effectiveness compared to daily 100 mg fluconazole tablets (Nairy et al , ).…”

Section: Is There Any Novelty In the Treatment Of Oral Manifestationsmentioning

confidence: 99%

Urban legends series: oral manifestations of HIV infection

et al. 2013

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Human immunodeficiency virus-related oral lesions (HIV-OLs), such as oral candidiasis (OC) and oral hairy leukoplakia (OHL), have been recognized as indicators of immune suppression since the beginning of the global HIV epidemic. The diagnosis and management of HIV disease and spectrum of opportunistic infection has changed over the past 30 years as our understanding of the infection has evolved. We investigated the following controversial topics: (i) Are oral manifestations of HIV still relevant after the introduction of highly active antiretroviral therapy (HAART)? (ii) Can we nowadays still diagnose HIV infection through oral lesions? (iii) Is the actual classification of oral manifestations of HIV adequate or does it need to be reviewed and updated? (iv) Is there any novelty in the treatment of oral manifestations of HIV infection? Results from extensive literature review suggested the following: (i) While HAART has resulted in significant reductions in HIV-OLs, many are still seen in patients with HIV infection, with OC remaining the most common lesion. While the relationship between oral warts and the immune reconstitution inflammatory syndrome is less clear, the malignant potential of oral human papillomavirus infection is gaining increasing attention. (ii) Effective antiretroviral therapy has transformed HIV from a fatal illness to a chronic manageable condition and as a result expanded screening policies for HIV are being advocated both in developed and in developing countries. Affordable, reliable, and easy-to-use diagnostic techniques have been recently introduced likely restricting the importance of HIV-OLs in diagnosis. (iii) The 1993 EC-Clearinghouse classification of HIV-OLs is still globally used despite controversy on the relevance of periodontal diseases today. HIV-OL case definitions were updated in 2009 to facilitate the accuracy of HIV-OL diagnoses by non-dental healthcare workers in large-scale epidemiologic studies and clinical trials. (iv) Research over the last 6 years on novel modalities for the treatment of HIV-OLs has been reported for OC and OHL.

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A pseudo-randomised clinical trial of in situ gels of fluconazole for the treatment of oropharngeal candidiasis

Cited by 12 publications

References 9 publications

Antimicrobial Photodynamic Therapy in the Treatment of Oral Candidiasis in HIV-Infected Patients

Antimicrobial Photodynamic Therapy in the Treatment of Oral Candidiasis in HIV-Infected Patients

Oral fungi inHIV: challenges in antifungal therapies

Urban legends series: oral manifestations of HIV infection

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