![]() ![]() The patients in the fluconazole group reported less inconvenience from taking the medication, a finding that may have clinical implications for compliance. These differences were not found to be statistically significant. Eight patients in the fluconazole group and 12 patients in the nystatin group exhibited a relapse within 6 months. Half of the patients in the nystatin group reported inconvenience from taking the medication (mean value = 25.9) compared with 23% of the patients in the fluconazole group (mean value = 6.6). The comparable figures for the nystatin group were 10 of 12 patients (83%). ![]() ¥ Our preferred dosing of echinocandins in adults with esophagitis is as follows: anidulafungin 200 mg IV daily caspofungin 70 mg daily or micafungin. Patients should swish in the mouth and retain for as long as possible (several minutes) before swallowing. Following treatment with fluconazole, 20 of 22 patients with symptoms at the start (91%) reported improvement. Nystatin suspension or pastilles (400,000 to 600,000 units orally 4 times daily). The corresponding figure for the nystatin group (n = 30), rinsing with 1 mL 4 times a day for 21 days, was 80%. After 7 days of treatment with fluconazole (50 mg/day), the affected oral mucosa, assessed by the investigator, was cured or showed considerable improvement in 87% of the patients (n = 30). One patient who was treated with nystatin was excluded owing to nausea that was related to the antifungal treatment. ![]() For the remaining patients no specific predisposing factors were found. Predisposing factors were xerostomia (n = 18), HIV (n = 5), immunosuppression in conjunction with organ transplantation (n = 10), and wearing of dentures (n = 14). I do not recommend the use of nystatin swish and swallow due to the high sugar content, potential nausea (which you have already experienced and relative ineffectiveness. Of the included patients (n = 60), two-thirds presented with an erythematous candidosis, and the others showed clinical signs compatible with a pseudomembranous candidosis. The efficacy of oral fluconazole versus nystatin was evaluated as a treatment modality for oral candidosis. ![]()
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