Use of nystatin and chlorhexidine in oral medicine: Properties, indications and pitfalls with focus on geriatric patients

Abstract

Further studies investigating new drugs and interactions of drug combinations are necessary to improve the therapeutic management of oral infections.

Therapeutic tools for oral candidiasis: Current and new antifungal drugs

“…The choice of antifungal drug should take into account the patient immune status, the specific characteristics of oral candidiasis (clinical presentation, aetiology, susceptibility to antifungal drugs, organic location, dissemination) and the pharmacological characteristics of the available antifungal drugs (administration, metabolism, elimination, interactions with other drugs and toxicity). Three large families group the most commonly used anti- Nystatin perficial mycoses, such as flucytosine, griseofulvin and terbinafine, are not used commonly in oral candidiasis (7,8,11,(14)(15)(16)(17). Finally, other therapeutic alternatives under development involve the use of new antifungal drugs, terpens, probiotics, peptides with antifungal activity, sera with polyclonal or monoclonal antibodies or cocktails of cytokines (18)(19)(20)(21)(22)(23)(24)(25).…”

“…Antifungal formulations are marketed as oral suspensions, tablets, pastilles, gels, mucoadhesive tablets, toothpastes, etc. for facilitating their therapeutic action that are very effective in curing most oral candidiasis in a few weeks (15,17,29). Although systemic azoles and echinocandins, with better tastes and less gastrointestinal adverse reactions, have provided new clinical options, topical therapy using nystatin (polyene) and miconazole (azole) are still the main recommended treatments for oral candidiasis due to its high efficacy, low cost, and less side effects, especially in low-income countries.…”

“…Although systemic azoles and echinocandins, with better tastes and less gastrointestinal adverse reactions, have provided new clinical options, topical therapy using nystatin (polyene) and miconazole (azole) are still the main recommended treatments for oral candidiasis due to its high efficacy, low cost, and less side effects, especially in low-income countries. The accumulated experience is important and their usefulness is clearly defined (7,8,(14)(15)(16)(17).…”

“…There are other pharmacological preparations that have antifungal activity and can be used in combination with antifungal drugs. These formulations include chlorhexidine, povidone iodine, solutions of gentian violet, potassium permanganate, methylene blue or sodium hyposulfite, propylene glycol, selenium sulphide, boric acid, and caffeic acid derivatives (17,21). Several investigational agents are currently under development against old targets, such as ergosterol (tetrazoles VT-1129, VT-1161, and VT-1598) or 1,3-β-D-glucan (extended half-life echinocandin CD101 or ibrexafungerp -SCY-078-) that may offer advantages over currently available drugs.…”

Hydroalcoholic Extract of Eugenia uniflora as Denture Disinfectant: Antimicrobial Activity and Effect on the Physical Properties of Polymethylmethacrylate

“…In comparison, a significant reduction in microbial load was perceived with chlorhexidine when compared with the extracts (Table 2). Still, the long-term exposure to chlorhexidine has been associated to drawbacks, such as denture discoloration, darkening of natural teeth, burning sensation, and changes in taste [27]. Therefore, the potentials of natural substances, such as neither affecting the denture structure nor causing harm to the individual, and being inexpensive and easy to use [15], should be considered.…”