Comparison of tea tree oil 5%, tea tree oil 10%, and nystatin inhibition zones against vaginal Candida isolates in pregnancy.

INTRODUCTION: Vulvovaginal candidiasis (VVC) in pregnancy frequently develops into recurrent infections. Clinical study suggests that conventional topical treatments for VVC are not always enough to eradicate Candida spp. from the vaginal microenvironment. This study aimed to evaluate the antifungal activity of tea tree oil (TTO) 5% and TTO 10% against Candida species causing VVC in pregnancy. METHODOLOGY: In vitro experimental study was conducted in the Mycology Laboratory at Dermatovenereology Outpatient Clinic Dr. Soetomo General Hospital Surabaya. Eighteen isolates of Candida species were isolated from the vaginal thrush of 15 pregnant women diagnosed with VVC from March to May 2021. Antifungal susceptibility of TTO 5% and TTO 10% was evaluated by the disc diffusion method, with the inhibitory zone diameter as the main outcome. RESULTS: The mean inhibitory zone diameter of TTO 5%, TTO 10%, and nystatin against all Candida spp. was 7.26 mm, 8.64 mm, and 25.57 mm, respectively (p < 0.001). The mean inhibitory zone diameter of TTO 5%, TTO 10%, and nystatin tend to be larger in C. albicans compared to the non-albicans, but the difference is not significant. Nystatin displayed the largest mean inhibitory zone diameters compared to TTO 5% and TTO 10% (p < 0.001) in all Candida species. Increased concentration from TTO 5% to TTO 10% resulted in a slight increment in the mean inhibitory zone diameters in all-Candida species (p = 0.001). CONCLUSIONS: Tea Tree Oil displayed antifungal activity against Candida species causing VVC in pregnancy. Further studies are required to investigate optimal TTO concentrations as a VVC treatment in pregnancy.

Curcumin nanoparticles: the topical antimycotic suspension treating oral candidiasis.

Phytotherapeutics is widely used nowadays as an alternative to the current antifungal drugs to reduce their side effects. Curcumin, with its wide therapeutic array as antioxidant and anti-inflammatory agent, is one of the natural compounds that ha..s an antifungal effect, especially when being used at nanoscale to increase its bioavailability. Our research aimed to evaluate clinically and microbiologically the effect of using topical nanocurcumin suspension to treat oral candidiasis. After 4 days from induction of oral candidiasis (baseline), we randomly divided 39 female BALB/c mice into three groups of 13 animals; nanocurcumin, nystatin, and sham groups. All animals in nanocurcumin and nystatin groups received topical treatment twice daily for 10 days. Then, we performed clinical and microbiological evaluations at baseline, day 5, and day 10. By the end of treatment, our results revealed that nanocurcumin promoted a significant reduction in the number of candida colonies. There was no statistically significant difference neither clinically nor microbiologically between nanocurcumin and nystatin groups. In conclusion, nanocurcumin has a good antifungal effect as nystatin, however, its therapeutic efficacy takes a longer time to appear than nystatin. The enhanced bioavailability of curcumin at the nanoscale qualifies this nano-herb as a promising alternative therapy for oral candidiasis, evading nystatin-associated morbidity.

Inhibitory Effect of Standardized Extract and Fractions of Nigella sativa L. on Nystatin Susceptible and Clinically Nystatin Resistant Candida albicans.

INTRODUCTION: Candidiasis infection is caused by different species of Candida, which are characterized by host immunologic weakness. Black cumin seeds (Nigella sativa) have shown an inhibitory effect against Candida albicans. In this work, the inhibitory effect of standardized extract and different fractions of Nigella sativa seeds has been evaluated on both nystatin-susceptible and resistant strain of C. albicans. MATERIALS AND METHODS: Canadida albicans (NSCA) with ATCC 76645 and nystatin-resistant Candida albicans (NRCA) were prepared from oral samples of HIV individuals. Total extract and different fractions of N. sativa were prepared using maceration and sonication methods. Thymoquinone (TQ) content of the plant was determined by spectrophotometric method. Total extract (TTE) and the fractions along with TQ were evaluated on NSCA and NRCA by the microdilution method. RESULTS: TQ content of the plant was 0.92 ± 0.37g/100g dried extract. The least MIC and MFC (62.5 and 125 µg/ml, respectively) were due to petroleum ether fraction (PEF) against both NSCA and NRCA, followed by chloroform fraction (CHF) with MIC and MFC of 125 and 250 µg/ml, respectively. TQ exhibited MIC of 0.78 and 3.12 µg/ml against NSCA and NRCA, stronger than nystatin (MIC of 2 and 16 µg/ml, respectively). Thymoquinone was detected in the PEF and CHF. CONCLUSION: Considering more inhibitory effects of PEF and CHF than TTE, we can conclude that active components of the plant belong to non-polar compounds. PEF showed identical inhibitory effects on NRCA and NSCA, which is a valuable result for finding novel medicaments against NRCA infections.

Synergistic effect of thymoquinone and nystatin in the treatment of oral candidiasis; an in vitro study.

The effectiveness of antifungal agents may be insufficient against resistant strains in some cases of oral candidiasis. The aim of this study was to evaluate the antifungal effect of thymoquinone against Candida albicans, Candida tropicalis, Candida glabrata and Candida krusei strains and the synergistic antifungal activity of these strains in combination with nystatin. To evaluate in vitro antifungal activity and interactions between thymoquinone and nystatin, substances were tested against Candida albicans ATCC 10,231, C. tropicalis ATCC 750, C.krusei ATCC 6258 and C. glabrata ATCC 2001 standard strains both individually and combinationally via microdilution method. MIC and ΣFIC index value were analysed. The Kruskal Wallis test and Bonferroni test were used for statistical evaluations. Statistical significance was set at p < 0.05. A statistically significant difference was observed between the mean ranks of all Candida species and doses of thymoquinone, nystatin, and the combination thymoquinone-nystatin (p < 0.05). MIC values for thymoquinone were determined as 15 µg/mL for C. albicans, C. tropicalis and C. krusei while it was 30 µg/mL for C. glabrata. Moreover, MIC for nystatin was found as 1.875 µg/mL for C. albicans, C. tropicalis and C. krusei, whereas it was 7.5 µg/mL in C. glabrata. Interaction assays and ΣFIC index value revealed that, TQ and nystatin have a synergistic effect against to all strains. Thymoquinone was found to have antifungal activity on Candida species and synergistic effect when combined with nystatin.

Efficacy of essential oil of cinnamon for the treatment of oral candidiasis: A randomized trial.

AIM: It was analyzed the efficacy of mouthwash and spray containing essential oil (EO) of Cinnamomum zeylanicum Blume for the treatment of oral candidiasis. METHODS AND RESULTS: A randomized, controlled, and blinded clinical trial was conducted with 36 individuals (probabilistic sample) with oral candidiasis who were divided into two treatment groups: C. zeylanicum (0.5 mg/mL), n = 18; nystatin (100,000IU/mL), n = 18. The efficacy of the products was evaluated by two parameters: (a) clinical evolution recorded by calibrated examiners (Kappa = 0.822) according to Newton's classification and (b) reduction of colony-forming units/mL. Mycological and clinical parameters were analyzed before and at 15 days after treatment. Clinical examination of the mucosa showed that C. zeylanicum (p < 0.0339) and nystatin (p < .0139) had efficacy, resulting in a reduction of signs and symptoms (Mann-Whitney test). Mycological analysis showed that C. zeylanicum caused a reduction of 61% and 33% of Candida spp., isolates oral mucosa and dentures, respectively. Candida tropicalis strains were eliminated after C. zeylanicum, in both sites. The participants reported a pleasant taste and few product-related complaints. CONCLUSION: C. zeylanicum EO and nystatin exhibited clinical efficacy, according to the Newton classification, and reducing in Candida spp. The clinical trial has been registered (Registration number: NBR-33s6 × 5, ensaiosclinicos.gov.br).

Cutaneous candidiasis - an evidence-based review of topical and systemic treatments to inform clinical practice.

Cutaneous candidiasis is a common skin disease, and several treatments have been investigated within the last fifty years. Yet, systematic reviews are lacking, and evidence-based topical and systemic treatment strategies remain unclear. Thus, the aim of this review was to summarize efficacy and adverse effects of topical and oral therapies for cutaneous candidiasis in all age groups. Two individual researchers searched PubMed and EMBASE for 'cutaneous candidiasis' and 'cutaneous candidiasis treatment', 'intertrigo', 'diaper dermatitis' and 'cheilitis'. Searches were limited to 'English language', 'clinical trials' and 'human subjects', and prospective clinical trials published in abstracts or articles were included. In total, 149 studies were identified, of which 44 were eligible, comprising 41 studies of 19 topical therapies and four studies of three systemic therapies for cutaneous candidiasis. Topical therapies were investigated in infants, children, adolescents, adults and elderly, while studies of systemic therapies were limited to adolescents and adults. Clotrimazole, nystatin and miconazole were the most studied topical drugs and demonstrated similar efficacy with complete cure rates of 73%-100%. Single-drug therapy was as effective as combinations of antifungal, antibacterial and topical corticosteroid. Four studies investigated systemic therapy, and oral fluconazole demonstrated similar efficacy to oral ketoconazole and topical clotrimazole. Limitations to this review were mainly that heterogeneity of studies hindered meta-analyses. In conclusions, clotrimazole, nystatin and miconazole were the most studied topical drugs and demonstrated equal good efficacy and mild adverse effects similar to combinations of antifungal, antibacterial and topical corticosteroids. Oral fluconazole was as effective as topical clotrimazole and is the only commercially available evidence-based option for systemic treatment of cutaneous candidiasis.

Therapeutic tools for oral candidiasis: Current and new antifungal drugs.

BACKGROUND: Candidiasis is one of the most common opportunistic oral infections that presents different acute and chronic clinical presentations with diverse diagnostic and therapeutic approaches. The present study carries out a bibliographic review on the therapeutic tools available against oral candidiasis and their usefulness in each clinical situation. MATERIAL AND METHODS: Recent studies on treatment of oral candidiasis were retrieved from PubMed and Cochrane Library. RESULTS: Nystatin and miconazole are the most commonly used topical antifungal drugs. Both antifungal drugs are very effective but need a long time of use to eradicate the infection. The pharmacological presentations of miconazole are more comfortable for patients but this drug may interact with other drugs and this fact should be assessed before use. Other topical alternatives for oral candidiasis, such as amphotericin B or clotrimazole, are not available in many countries. Oral fluconazole is effective in treating oral candidiasis that does not respond to topical treatment. Other systemic treatment alternatives, oral or intravenous, less used are itraconazole, voriconazole or posaconazole. Available novelties include echinocandins (anidulafungin, caspofungin) and isavuconazole. Echinocandins can only be used intravenously. Isavuconazole is available for oral and intravenous use. Other hopeful alternatives are new drugs, such as ibrexafungerp, or the use of antibodies, cytokines and antimicrobial peptides. CONCLUSIONS: Nystatin, miconazole, and fluconazole are very effective for treating oral candidiasis. There are systemic alternatives for treating recalcitrant infections, such as the new triazoles, echinocandins, or lipidic presentations of amphotericin B.

Isolation of Candida auris from Ear of Otherwise Healthy Patient, Austria, 2018.

The emerging pathogen Candida auris is isolated mostly from hospitalized patients and often shows multidrug resistance. We report on the isolation of this yeast in Austria from an outpatient's auditory canal. The isolate showed good susceptibility against antifungals except for echinocandins; the patient was treated successfully with topical administration of nystatin.

Current Trends in the Use of Two Combination Antifungal/Corticosteroid Creams.

Superficial fungal infections are among the most commonly managed skin problems by general practitioners. Although evidence shows combination antifungal/corticosteroid topicals are more expensive and less effective than single-agent antifungals, practitioners continue to prescribe combination agents. We examined current prescription trends of 2 combination antifungal/corticosteroid medications, Lotrisone and Mycolog-II.

Identification of multi-targeted anti-migraine potential of nystatin and development of its brain targeted chitosan nanoformulation.

The complex pathophysiology involved in migraine necessitates the drug treatment to act on several receptors simultaneously. The present investigation was an attempt to discover the unidentified anti-migraine activity of the already marketed drugs. Shared featured pharmacophore modeling was employed for this purpose on six target receptors (ß2 adrenoceptor, Dopamine D3, 5HT1B, TRPV1, iGluR5 kainate and CGRP), resulting in the generation of five shared featured pharmacophores, which were further subjected to virtual screening of the ligands obtained from Drugbank database. Molecular docking, performed on the obtained hit compounds from virtual screening, indicated nystatin to be the only active lead against the receptors iGluR5 kainate receptor (1VSO), CGRP (3N7R), ß2 adrenoceptor (3NYA) and Dopamine D3 (3PBL) with a high binding energy of -11.1, -10.9, -10.2 and -12kcal/mole respectively. The anti-migraine activity of nystatin was then adjudged by fabricating its brain targeted chitosan nanoparticles. Its brain targeting efficacy, analyzed qualitatively by confocal laser scanning microscopy, demonstrated a significant amount of drug reaching the brain. The pharmacodynamic models on Swiss male albino mice revealed significant anti-migraine activity of the nanoformulation. The present study reports for the first time the therapeutic potential of nystatin in migraine management, hence opening avenues for its future exploration.

Identificación y sensibilidad antifúngica in vitro de Candida spp. de origen vaginal a fluconazol, clotrimazol y nistatina / Identification and in vitro antifungal susceptibility of vaginal Candida spp. isolates to fluconazole, clotrimazole and nystatin

Objetivo. Identificar especie y determinar la sensibilidad in vitro a clotrimazol, fluconazol y nistatina de 145 aislamientos de Candida spp. Material y métodos. Se utilizó un método de microdilución en caldo (M27-A3) para determinar la concentración inhibitoria mínima (CMI) y además las CMI50 y CMI90 de los antifúngicos. De los 145 aislamientos, 126 correspondieron a C. albicans, 16 C. glabrata, 2 C. parapsilosis y 1 C. tropicalis. Resultados. La CMI50 y CMI90 de fluconazol frente C. albicans fueron de 0,25 mg/L y 1 mg/L y para C. glabrata de 8 y 16 mg/L, respectivamente. Cinco aislados de C. albicans y un aislado de C. tropicalis fueron resistentes a fluconazol (M27- S4). Las CIM50 y CIM90 de clotrimazol frente a C. albicans fueron 0,03 mg/L y 0,06 mg/L y para C. glabrata de 0,25 mg/L y 1 mg/L, mientras que para nistatina fueron de 1 mg/L y de 2 mg/L, respectivamente para C. albicans y C. glabrata. Cinco aislados de C. glabrata y 1 de C. tropicalis fueron resistentes a clotrimazol. Conclusión. En este estudio, C. albicans es la levadura más frecuentemente aislada, seguida de C glabrata. Los antifúngicos evaluados resultaron ser activos in vitro para las cepas aisladas, excepto en 6 aislados para fluconazol y 6 para clotrimazol (AU)

Objective. The aim of this study was to identify and determine the in vitro antifungal susceptibility testing to clotrimazole, fluconazole, and nystatin of 145 clinical isolates of Candida spp. Material and methods. M27-A3 microdilution method was used to determine minimal inhibitory concentrations (MIC) and partial MICs (MIC50 and MIC90) of drugs. A total of 145 isolates were studied, 126 were C. albicans, 16 C. glabrata, 2 C. parapsilosis y 1 C. tropicalis. Results. MIC50 and MIC90 for FLZ against C. albicans were 0.25 mg/L and 1 mg/L respectively and for C. glabrata was achieved at 8 mg/L and 16 mg/L for fluconazole. Five isolates of C. albicans and one isolate of C. tropicalis were in vitro resistant to fluconazole (M27-S4). In C. albicans MIC50 and MIC90 for clotrimazole were of 0.03 mg/L and 0.06 mg/L, respectively. These values for C. glabrata were 0.25 mg/L and 1 mg/L, respectively. Five C. glabrata and 1 C. tropicalis were in vitro resistant to clotrimazole. MIC50 and MIC90 of nystatin were of 1 mg/L and 2 mg/L, respectively for C. albicans and C. glabrata. Conclusion. In this study, C. albicans is the most frequently isolated yeast, followed by C glabrata. The antifungals tested were found to be in vitro active for the isolates, except for 6 isolates for fluconazole and 6 to clotrimazole (AU)

Evaluation of the anti-candidal activity of methanolic leaf extract of cleistopholis patens (fam. Annonaceae) on candida species isolated from stage II HIV patients.

BACKGROUND: Candida species (sp) is implicated in causing opportunistic disseminated mycotic complications in stage II HIV patients. Cleistopholis patens is a West African medicinal tree reported to have significant antifungal activity against C. albicans. OBJECTIVES: This study aimed to determine the anti-candidal activity of methanolic leaf extract of Cleistopholis patens against Candida species isolated from stage II HIV patients. METHODS: The minimum inhibitory concentration (MIC) of the extract and Nystatin®® was determined by agar dilution method. The killing rate studies of the plant extract and Nystatin® were also determined. RESULTS: The extract had activity against all Candida isolates, with the MIC against the five isolates ranging from 6.0 - 9.8 mg/ml. Nystatin® also demonstrated plausible activity against the isolates with MICs ranging from 0.3125 - 25 mg/ml. Candida albicans strain 2 was the most sensitive to both extract and Nystatin® with MIC values of 6 and 0.3125 mg/ml respectively. Candida krusei was the least sensitive with MIC values of 9.8 and 25 mg/ml for the extract and Nystatin® respectively. The killing rate values for the extract ranged from -0.029 to -0.091 min(-1) and that of Nystatin® ranged from -0.076 to -0.11216 min(-1). CONCLUSIONS: The results indicate that the methanolic extract of Cleistopholis patens is a promising clinical alternative besides Nystatin® in the treatment of infections caused by Candida species in stage II HIV patients.

Candida parapsilosis sensu stricto and the closely related species Candida orthopsilosis and Candida metapsilosis in vulvovaginal candidiasis.

This study aimed to determine the clinical characteristics and in vitro susceptibilities of Candida parapsilosis sensu stricto, Candida orthopsilosis and Candida metapsilosis isolates from patients with vulvovaginal candidiasis (VVC). We analysed 63 vaginal C. parapsilosis specimens. After the molecular analyses, the isolates were characterised as C. parapsilosis sensu stricto (77.8%), C. orthopsilosis (7.9%) and C. metapsilosis (14.3%). The signs and symptoms of VVC caused by C. parapsilosis sensu lato, including itching, erythema and abnormal discharge, were milder than those caused by C. albicans. None of the C. parapsilosis sensu lato isolates were resistant to fluconazole, miconazole or itraconazole. The resistance rates of C. albicans to fluconazole, itraconazole, miconazole and clotrimazole were 2.3, 1.5, 3.1 and 0.8%, respectively. Both C. parapsilosis sensu lato and C. albicans were susceptible to nystatin. The mycological eradication rate at follow-up days 7-14 and 30-35 were 77.8% (49/63) and 76.2% (48/63), respectively, when treated with various antifungal agents and regimens. We conclude that C. parapsilosis sensu stricto and the closely related species C. orthopsilosis and C. metapsilosis were present in the vaginal samples of VVC patients. The symptoms and signs of VVC caused by C. parapsilosis are milder than those caused by C. albicans. The antifungal susceptibility and therapeutic efficacy in patients colonised by C. parapsilosis sensu lato were similar to those observed in C. albicans-colonised patients.

Vaginal nystatin versus oral fluconazole for the treatment for recurrent vulvovaginal candidiasis.

Recurrent vulvovaginal candidiasis (RVVC) is a common condition that can physically and psychologically impact patients. We compared the efficacy and safety of vaginal nystatin suppositories for 14 days each month versus standard oral fluconazole regimens for the treatment for RVVC. Patients (n = 293) were enrolled in the study from April 2010 to September 2013. After the initial therapy, the mycological cure rates were 78.3% (119/152) and 73.8% (104/141) in the nystatin group and fluconazole group, respectively (95% CI, 0.749-2.197, p > 0.05). The mycological cure rates at the end of maintenance therapy were 80.7% (96/119) and 72.7% (72/99) in the two groups, respectively (95% CI, 0.954-3.293, p > 0.05).The mycological cure rates at the end without treatment for 6 months were 81.25% (78/96) and 82.19% (60/73) in the two groups, respectively (95% CI, 0.427-2.066, p > 0.05). The mycological cure rates of RVVC caused by C. albicans were 84.0% (89/106) and 81.8% (99/121) in the two groups, respectively. The mycological cure rates of RVVC caused by C. glabrata were 64.3% (27/42) and 12.5% (2/16) in the two groups, respectively. The initial and 6-month maintenance therapy were successful in five of the nine patients in the nystatin group with RVVC caused by fluconazole-resistant Candida, whereas in the fluconazole group, initial therapy failed in all patients with RVVC caused by fluconazole-resistant Candida (n = 7). We conclude that both fluconazole and nystatin therapies are effective in treating RVVC. Nystatin may also be effective for the treatment for RVVC caused by C. glabrata or fluconazole-resistant Candida.

The comparative study of antifungal activity of Syzygium aromaticum, Punica granatum and nystatin on Candida albicans; an in vitro study.

AIM: Candida species are opportunistic fungi, among which, Candida albicans is the most important species responsible for infections in immunocompromised patients with invasive fungal disease. Resistance of Candida species to antifungal drugs has led scientists to pay more attention to traditional medicine herbs. Due to the limitations in the treatment of fungal diseases such as shortages, high prices, antifungal side effects and drug resistance or reduced susceptibility to fungal drugs we decided to study the antifungal effects of herbal extracts of Syzygium aromaticum and Punica granatum. METHODS: Twenty-one isolates of oral C. albicans in patients with denture stomatitis referred to prosthesis department, Dental faculty of Tehran University of Medical Sciences were prepared and cultured. Plant extracts were prepared from the herbs market. Tests on patient samples and standard strains 5027ATCC (PTCC10231) yeast C. albicans were performed via well diffusion method. In addition, nystatin and methanol were used as positive and negative control, respectively. Finally, the antifungal effect of extracts using Statistical Repeated measurement ANOVA test was investigated. RESULTS: Both S. aromaticum and P. granatum showed noticeable antifungal activity in well method. Syzygium aromaticum showed better anti candida activity than nystatin (P<0.001). CONCLUSION: Due to increasing problems with fungal diseases, these findings suggest that the plant extracts of S. aromaticum and P. granatum showed good antifungal effects (P-value<0.001). S. aromaticum (inhibition zone diameter: 29.62) showed better antifungal effects than nystatin (inhibition zone diameter: 28.48).

Amphotericin B versus fluconazole for controlling fungal infections in neutropenic cancer patients.

BACKGROUND: Systemic fungal infection is considered to be an important cause of morbidity and mortality in cancer patients, particularly those with neutropenia. Antifungal drugs are often given prophylactically, or empirically to patients with persistent fever. OBJECTIVES: To compare the effect of fluconazole and amphotericin B on morbidity and mortality in patients with cancer complicated by neutropenia. SEARCH METHODS: We searched PubMed from 1966 to 7 July 2014 and the reference lists of identified articles. SELECTION CRITERIA: Randomised clinical trials comparing fluconazole with amphotericin B. DATA COLLECTION AND ANALYSIS: The two review authors independently assessed trial eligibility and risk of bias, and abstracted data. MAIN RESULTS: Seventeen trials (3798 patients, 381 deaths) were included. In two large three-armed trials, results for amphotericin B were combined with results for nystatin in a 'polyene' group. Because nystatin is an ineffective drug in these circumstances, this approach creates a bias in favour of fluconazole. Furthermore, most patients were randomised to oral amphotericin B, which is poorly absorbed and poorly documented. There was overlap among the 'polyene' trials but we were unable to obtain any information from the trial authors or from Pfizer, the manufacturer of fluconazole, to clarify these issues. There were no significant differences in effect between fluconazole and amphotericin B, but the confidence intervals were wide. More patients dropped out of the study when they received amphotericin B, but as none of the trials were blinded decisions on premature interruption of therapy could have been biased. Furthermore, amphotericin B was not given under optimal circumstances, with premedication to reduce infusion-related toxicity, slow infusion, and with fluid, potassium and magnesium supplements to prevent nephrotoxicity. The major harms were hepatic impairment and gastrointestinal adverse effects with fluconazole and infusion-related toxicity, renal impairment and gastrointestinal adverse effects with amphotericin B. For the 2011 and 2014 updates no additional trials were identified for inclusion. AUTHORS' CONCLUSIONS: Amphotericin B has been disfavoured in several of the trials through their design or analysis, or both. Since intravenous amphotericin B is the only antifungal agent for which an effect on mortality has been shown, and since it is considerably cheaper than fluconazole, it should be the preferred agent.

Ricinus communis treatment of denture stomatitis in institutionalised elderly.

This study compared the effectiveness of Ricinus communis (RC) with Nystatin (NYS) and Miconazole (MIC) in the treatment of institutionalised elderly with denture stomatitis (DS). They (n = 30) were randomly distributed into three groups: MIC, NYS or RC. Clinical and mycological evaluations were performed prior to the use of the antifungal (baseline) and repeated after 15 and 30 days of treatment. The sample was clinically examined for oral mucosal conditions. Standard photographs were taken of the palate, and the oral candidiasis was classified (Newton's criteria). Mycological investigation was performed by swabbing the palatal mucosa, and Candida spp. were quantified by counting the number of colony-forming units (cfu mL⁻¹). The clinical and mycological data were analysed, respectively by Wilcoxon and Student's t-test (α = 0.05). Significant improvement in the clinical appearance of DS in the MIC and RC groups was observed between the 1st and 3rd collections (MIC - P = 0.018; RC - P = 0.011) as well as between the 2nd and 3rd collections (MIC - P = 0.018; RC - P = 0.011). Neither groups showed a statistically significant reduction in cfu mL⁻¹ at any time. Although none of the treatments decreased the cfu mL⁻¹, it was concluded that Ricinus communis can improve the clinical condition of denture stomatitis in institutionalised elderly patients, showing similar results to Miconazole.

Actividad antimicrobiana del cloruro de 2-metacriloil oxietil trimetilamonio contra Candida sp / Antimicrobial activity of [2-(methacryloyloxy)ethyl]trimethylammonium chloride against Candida spp

Antecedentes. La estomatitis protética es la forma más común de infección bucal producida por especies de Candida, siendo Candida albicans el agente etiológico más común. Diversos autores han intentado asociar agentes antifúngicos o antisépticos a los materiales de revestimiento blando o a las resinas acrílicas de las prótesis dentales, pero sin éxito. Por ello, se ha investigado un compuesto de amonio cuaternario (2-metacriloil oxietil trimetilamonio [MADQUAT]), que copolimeriza con los metacrilatos y que podría actuar como inhibidor de levaduras. Objetivos. El objetivo de este estudio fue evaluar la actividad in vitro del MADQUAT contra especies de Candida. Métodos. Se utilizaron 31 cepas de Candida para determinar la actividad antifúngica in vitro. Se determinó la concentración mínima inhibitoria (CMI) y la concentración mínima fungicida del MADQUAT, así como de la nistatina. Resultados. El MADQUAT presentó propiedades antifúngicas en las concentraciones entre 6,25 y > 100mg/ml y actividad fungicida entre 25 y > 100mg/ml. Los estudios cuantitativos de la actividad fungistática y fungicida del MADQUAT demostraron actividad fungistática contra todas las cepas de Candida albicans, Candida krusei y Candida parapsilosis, revelando actividad fungicida contra algunas cepas de otras especies. Conclusiones. El MADQUAT presenta actividad antifúngica contra Candida spp. Además, la sensibilidad a dicho compuesto es distinta entre las diferentes especies considerando los valores de la CMI y la actividad fungicida o fungistática(AU)

Background. Candida-associated denture stomatitis is the most common manifestation of oral candidal infection, caused mainly by Candida albicans. Several authors have attempted to add antifungal agents or antiseptics to denture temporary soft lining materials or to denture acrylic resins, without relevant results. Therefore, the investigation of a quaternary ammonium functionalized compound [2-(methacryloyloxy)ethyl]trimethylammonium chloride (MADQUAT), which copolymerizes with methacrylates and which could act as a fungal inhibitor, is of paramount importance. Aims. To evaluate the in vitro activity of MADQUAT against Candida species. Methods. Thirty-one Candida strains were used to determine the in vitro antifungal activity of this compound. The minimum inhibitory concentrations and minimum fungicidal concentrations of MADQUAT and nystatin were determined. Results. MADQUAT showed antifungal properties at concentrations of 6.25 to > 100mg/ml, and fungicidal activity between 25 and > 100mg/ml. The quantitative determinations of the fungistatic and fungicidal activity of MADQUAT showed fungistatic activity against all Candida albicans, Candida krusei and Candida parapsilosis strains, revealing fungicidal activity against some strains of the other species. Conclusions. MADQUAT has antifungal activity against Candida spp. Moreover, the sensitivity to this substance varies across the different species in terms of MIC values and fungicidal or fungistatic activity(AU)

The use of konjac glucomannan hydrolysates to recover healthy microbiota in infected vaginas treated with an antifungal agent.

The aim of this study was to evaluate how konjac glucomannan hydrolysates (GMH) could support the healthy re-colonisation of vaginal microflora post infections. A total of 26 female patients (12 controls and 14 treatments) aged 18 to 25 suffering from vaginal infection were recruited for this study. Patients were assigned randomly into two groups to receive a standard antifungal treatment or a standard antifungal treatment plus pessary capsules containing 200 mg GMH (twice a week for thirty days). Patients were assessed on day zero, sixteen and thirty of the trial. Several parameters were determined including yeast and bacterial counts, the KOH test, pH, Gram staining and wet mount microscopic observations. The results showed that the counts of Candida were diminished completely with antifungal treatment for both groups. However, the total bacterial counts increased with time in the GMH pessary group unlike the control. The normalised average KOH scores were reduced sharply with time in both groups although in the control group scores started to increase after sixteen days. The normalised average white blood cell scores also decreased with time for both groups. Epithelial cell scores decreased only for the GMH pessary group while clue cells and yeast-like fungi decreased with time for both control and GMH pessary groups. These results indicate the improvement of vaginal health recovery (post antifungal treatment for Candida infection) and especially the presence of healthy microflora due to the introduction of GMH in the vagina. The data indicate that it would be worth examining further the health benefits of GMH in a vaginal health format with a view to employing the material as a prophylactic or therapeutic agent. It provides an alternative approach to reducing vaginal infections and promoting consumer health.

Comparison of therapeutic effect of aqueous extract of garlic and nystatin mouthwash in denture stomatitis.

INTRODUCTION: Denture stomatitis (DS) is the most common form of chronic oral candidiasis. The standard treatment for DS is nystatin, which is accompanied with complications such as a bitter taste. The aim of this study was to compare the effect of garlic with nystatin in DS. MATERIAL AND METHODS: This randomised clinical trial study was performed on 40 patients with DS. After obtaining written consent, patients were divided into two groups while members of each group were given either nystatin or garlic extract for 4 weeks. The length and width of erythema area was measured at the end of the first, second, third, and the fourth weeks using a calliper. Data were analysed by SPSS and statistical tests including variance analysis with anova repeated measures, chi-square, and least square differences. RESULTS: The changes in the length and width of erythema at different times according to the type of treatment were found to be significant while an accelerated recovery was demonstrated for nystatin (p < 0.001). Both regimens resulted in significant recovery (p < 0.0001). Greater satisfaction with the use of garlic rather than nystatin was mentioned (p < 0.0001). CONCLUSION: Considering the efficacy of garlic and lack of side effects for this compound and also regarding the nystatin-associated complications, garlic extract can be introduced as a substitution for standard treatment in DS.