Oropharyngeal candidiasis: a review of its clinical spectrum and current therapies

Epstein, Joel B.; Polsky, Bruce

doi:10.1016/s0149-2918(98)80033-7

Cited by 92 publications

(69 citation statements)

References 66 publications

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“…There are several classes of candidiasis, which have become more common in recent years [4,6,13,17,40,41].…”

Section: Dubliniensis C Parapsilosis C Orthopsilosis C Metapsilmentioning

confidence: 99%

“…In children and young people, it may be involved with oral ("thrush") and lingual disease. In addition, and despite being very rare, esophageal candidiasis can occur in patients infected by HIV and cancer [2,5,40,[53][54][55].…”

Section: Oral Candidiasismentioning

confidence: 99%

“…During pregnancy, Candida species colonization increases 30-40%, depending upon altered immune response, bacterial flora, positive variations of glycogen and pH levels; however, mostly during the normal life cycle, other factors can affect, such as hygiene and oral contraceptive use, which contributes to 5-30% of the infections. In men, up to 10% of these species are found on the genitalia, in the transitional zone, between the mucous membrane and the skin [1,13,18,40,44,46]. The overgrowth of C. albicans is an important cause of a wide variety of symptoms that affect directly the wellbeing of individuals, therefore there is an urgent need to recognize candidiasis as a complex medical syndrome and evaluate the magnitude of the problem regarding prevention, which passes through the control of risk factors.…”

Section: Predisposing Factorsmentioning

confidence: 99%

“…Another important situation observed in most individuals with chronic candidiasis, is the presence of food allergies, therefore all known allergens should be eliminated [40,42,55,57,[59][60][61]. Thus, dietary factors should be monitored according to the needs of each individual.…”

Section: Dietary Factors and Nutrients Deficiencymentioning

confidence: 99%

“…This is the case of some increasing prevalence diseases, such as cancer, diabetes, and hypothyroidism, that in addition to debilitate immune system of individuals, has led to a continuous and exacerbated prescription of immunosuppressant drugs [1,11,17,18,24,37,40,41,[67][68][69].…”

Section: Impaired Immune System and Underlying Disease Statesmentioning

confidence: 99%

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Candidiasis: Predisposing Factors, Prevention, Diagnosis and Alternative Treatment

et al. 2014

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SUMMARYCandidiasis is the most common opportunistic yeast infection. Candida species and other microorganisms are involved in this complicated fungal infection, but Candida albicans continues to be the most prevalent. In the past two decades, it has been observed an abnormal overgrowth in the gastrointestinal, urinary and respiratory tracts, not only in immunocompromised patients, but also related to nosocomial infections and even in healthy individuals. There is a widely variety of causal factors that contribute to yeast infection which means that candidiasis is a good example of a multifactorial syndrome. Due to rapid increase in the incidence of these infections, this is the subject of numerous studies. Recently, the focus of attention is the treatment and, above all, the prevention of those complications. The diagnosis of candidiasis could become quite complicated. Prevention is the most effective "treatment", much more than eradication of the yeast with antifungal agents. There are several aspects to consider in the daily routine that can provide a strength protection. However, a therapeutic approach is necessary when the infection is established and, therefore, other alternatives should be explored. This review provides an overview on predisposition factors, prevention and diagnosis of candidiasis, highlighting alternative approaches for candidiasis treatment.

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“…There are several classes of candidiasis, which have become more common in recent years [4,6,13,17,40,41].…”

Section: Dubliniensis C Parapsilosis C Orthopsilosis C Metapsilmentioning

confidence: 99%

Section: Oral Candidiasismentioning

confidence: 99%

Section: Predisposing Factorsmentioning

confidence: 99%

Section: Dietary Factors and Nutrients Deficiencymentioning

confidence: 99%

Section: Impaired Immune System and Underlying Disease Statesmentioning

confidence: 99%

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Candidiasis: Predisposing Factors, Prevention, Diagnosis and Alternative Treatment

et al. 2014

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Interventions for the prevention and management of oropharyngeal candidiasis associated with HIV infection in adults and children

Pienaar

Young

Holmes

2006

Cochrane Database of Systematic Reviews

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Implications for practiceDue to only one study in children it is not possible to make recommendations for treatment or prevention of OC in children. Amongst adults, there were few studies per comparison. Due to insufficient evidence no conclusion could be made about the effectiveness of clotrimazole, nystatin, amphotericin B, itraconazole or ketoconazole with regard to OC prophylaxis. In comparison to placebo, fluconazole is an effective preventative intervention. However, the potential for resistant Candida organisms to develop, as well as the cost of prophylaxis, might impact the feasibility of implementation. No studies were found comparing fluconazole with other interventions. Direction of findings suggests that ketoconazole, fluconazole, itraconazole and clotrimazole improved the treatment outcomes. Implications for researchThere is an urgent need for gentian violet and other less expensive anti-fungal drugs for OC treatment to be evaluated in larger studies. More well designed treatment trials with larger sample size are needed to allow for sufficient power to detect differences in not only clinical, but also mycological response and relapse rates. There is also a strong need for more research to be done on the treatment and prevention of OC in children as it is reported that OC is the most frequent fungal infection in children and adolescents who are HIV positive. More research on the effectiveness of less expensive interventions also needs to be done in resource-poor settings. Currently few trials report outcomes related to quality of life, nutrition, or survival. Future researchers should consider measuring these when planning trials. Development of resistance remains under-studied and more work must be done in this area. It is recommended that trials be more standardised and conform more closely to CONSORT as this will improve research and also clinical practice.

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Interventions for the prevention and management of oropharyngeal candidiasis associated with HIV infection in adults and children

Pienaar

Young

Holmes

2010

Cochrane Database of Systematic Reviews

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Five new studies were added to the review, but their results do not alter the final conclusion of the review.Implications for practice Due to there being only one study in children, it is not possible to make recommendations for treatment or prevention of OC in children. Amongst adults, there were few studies per comparison. Due to insufficient evidence, no conclusion could be made about the effectiveness of clotrimazole, nystatin, amphotericin B, itraconazole or ketoconazole with regard to OC prophylaxis. In comparison to placebo, fluconazole is an effective preventative intervention. However, the potential for resistant Candida organisms to develop, as well as the cost of prophylaxis, might impact the feasibility of implementation. No studies were found comparing fluconazole with other interventions. The direction of findings suggests that ketoconazole, fluconazole, itraconazole and clotrimazole improved the treatment outcomes.Implications for research It is encouraging that low-cost alternatives are being tested, but more research needs to be on in this area and on interventions like gentian violet and other less expensive anti-fungal drugs to treat OC. More well-designed treatment trials with larger samples are needed to allow for sufficient power to detect differences in not only clinical, but also mycological, response and relapse rates. There is also a strong need for more research to be done on the treatment and prevention of OC in children as it is reported that OC is the most frequent fungal infection in children and adolescents who are HIV positive. More research on the effectiveness of less expensive interventions also needs to be done in resource-poor settings. Currently few trials report outcomes related to quality of life, nutrition, or survival. Future researchers should consider measuring these when planning trials. Development of resistance remains under-studied and more work must be done in this area. It is recommended that trials be more standardised and conform more closely to CONSORT.

show abstract

Oropharyngeal candidiasis: a review of its clinical spectrum and current therapies

Cited by 92 publications

References 66 publications

Candidiasis: Predisposing Factors, Prevention, Diagnosis and Alternative Treatment

Candidiasis: Predisposing Factors, Prevention, Diagnosis and Alternative Treatment

Interventions for the prevention and management of oropharyngeal candidiasis associated with HIV infection in adults and children

Interventions for the prevention and management of oropharyngeal candidiasis associated with HIV infection in adults and children

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