Abstract
BackgroundCandidiasis 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 MethodsRecent studies on treatment of oral candidiasis were retrieved from PubMed and Cochrane Library.ResultsNystatin 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.ConclusionsNystatin, 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. Key words:Oral candidiasis, antifungal treatment, azoles, echinocandins, fluconazole, miconazole, nystatin.
Highlights
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
Oral candidiasis is one of the most common opportunistic buccal infection that is caused by Candida albicans and other species included in the genus Candida
Treatment of oral candidiasis is based on three foundations: Early and accurate diagnosis of the type of oral candidiasis, correction of the predisposing factors or underlying diseases, and the use of the most appropriate antifungal drugs
Summary
Oral candidiasis (candidosis) is one of the most common opportunistic buccal infection that is caused by Candida albicans and other species included in the genus Candida. Candidiasis commonly presents as a mild disease of the oral mucous membranes, but sometimes can be recalcitrant to treatment or become relapsing or recurrent This oral infection is more frequent in people with extreme ages, or suffering from very diverse underlying diseases and, above all, in patients with immunodeficiency. Candida can be part of the human oral microbiota of up to 75% of persons without known underlying diseases This colonization occurs from birth and is greatest in the extreme ages of life (infants, children and the elderly). Candidiasis are observed more frequently in patients of extreme ages, with alterations of the skin-mucous barriers by surgical interventions, receiving parenteral nutrition, treated with broad-spectrum antibiotics or/and corticoids, and presence of neutropenia or immunodeficiency. Management of patients who have received previous antifungal treatments, who suffer relapsing infections and when candidiasis are caused by species different to C. albicans. There are still many controversial issues in the microbiological diagnosis in denture stomatitis and other Candida-associated lesions that need to be solved [9,11,13]
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