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Affiliation(s)
| | - Alina G Bridges
- Departments of Dermatology and Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN.
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Song R, Yan F, Cheng M, Dong F, Lin Y, Wang Y, Song B. Ultrasound-Assisted Preparation of Exopolysaccharide/Nystatin Nanoemulsion for Treatment of Vulvovaginal Candidiasis. Int J Nanomedicine 2020; 15:2027-2044. [PMID: 32273700 PMCID: PMC7104221 DOI: 10.2147/ijn.s241134] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 03/06/2020] [Indexed: 01/04/2023] Open
Abstract
PURPOSE As one of the classic anti-Canidia albicans (CA) and vulvovaginal candidiasis (VVC) drugs, nystatin (NYS) is limited by poor water solubility and easy aggregation. Traditional NYS vaginal delivery formulations do not fully adapt to the specific environment of the vaginal cavity. The use of exopolysaccharides (EPS) has great application potential in emulsifiers, but its use has not been reported in nanoemulsions. In this work, an EPS/NYS nanoemulsion (ENNE) was developed to improve the activities of NYS against CA and VVC. METHODS The ENNE was prepared by ultrasonic method using EPS as an emulsifier, liquid paraffin oil as an oil phase, PEG400 as a co-emulsifier, and NYS as the loaded drug. ENNE preparation was optimized by response surface method. After optimization, in vitro and in vivo analysis of the anti-CA activity; animal experiments; staining with propidium iodide (PI), periodic acid-schiff (PAS), and hematoxylin-eosin (H&E); and cytokine experiments were performed to investigate the therapeutic ability against VVC. RESULTS The optimal formulation and preparation parameters of ENNE were determined as follows: EPS content of 1.5%, PEG400 content of 3.2%, NYS content of 700 μg/mL, paraffin oil content of 5.0%, ultrasonic time of 15 min, and ultrasonic amplitude of 35%. The ENNE showed an encapsulated structure with an average particle size of 131.1 ± 4.32 nm. ENNE exhibited high storage and pH stability, as well as slow release. The minimum inhibitory concentration (MIC) of ENNE against CA was only 0.125 μg/mL and the inhibition zone was 19.0 ± 0.5 mm, for greatly improved anti-CA effect. The prepared ENNE destroyed the membrane of CA cells, and exhibited good anti-CA effect in vivo and therapeutic ability against VVC. CONCLUSION The results of this study will promote the application of EPS in nanotechnology, which should lead to new and effective local drug formulations for treating VVC.
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Affiliation(s)
- Ruiteng Song
- School of Pharmacy, Weifang Medical University, Weifang, Shandong261053, People’s Republic of China
| | - Fang Yan
- School of Pharmacy, Weifang Medical University, Weifang, Shandong261053, People’s Republic of China
| | - Min Cheng
- Clinical Medical College, Weifang Medical University, Weifang, Shandong261053, People’s Republic of China
| | - Fakun Dong
- School of Pharmacy, Weifang Medical University, Weifang, Shandong261053, People’s Republic of China
| | - Yongqi Lin
- School of Pharmacy, Weifang Medical University, Weifang, Shandong261053, People’s Republic of China
| | - Yuzhen Wang
- Medical Imaging Specialty, Weifang Medical University, Weifang, Shandong261053, People’s Republic of China
| | - Bo Song
- School of Pharmacy, Weifang Medical University, Weifang, Shandong261053, People’s Republic of China
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Škerk V, Kolumbić Lakoš A, Gašparić M, Matrapazovski Kukuruzović M, Magdić Blažević I. Effectiveness and Pharmacokinetic evaluation of Geonistin® (Oxytetracyline and Nystatin) Vaginal Tablets for Unspecific and Mixed Vulvovaginal Infections (GENIE Study). Acta Dermatovenerol Croat 2019; 27:235-244. [PMID: 31969236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The GENIE study was performed to evaluate the effectiveness and systemic exposure to oxytetracycline in local treatment of unspecific and mixed vulvovaginal infections characterized by vaginal discharge with Geonistin® vaginal tablets (100 mg oxytetracycline and 100 000 IU nystatin). The total number of subjects enrolled was 189. The treatment had beneficial effects in 100% of the study population. According to the Nugent score, the treatment had a positive effect in 89.2% of participants. The microbiological cure rate was 78.8%. Oxytetracycline concentration levels were from 13.3 to 32.2 ng/mL in 11 out of 15 subjects, and in four subjects the levels were below 10 ng/mL. Geonistin® had a beneficial effect on the unspecific and mixed vulvovaginal infections characterized by vaginal discharge in all efficacy and safety outcomes. Microbiological and the Nugent score efficacy measures confirmed clinical effectiveness. Beneficial efficacy results were achieved with only a few non-serious adverse events.
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Maqsood I, Masood MI, Nawaz HA, Shahzadi I, Arslan N. Formulation, characterization and in vitro evaluation of antifungal activity of Nystatin micro emulsion for topical application. Pak J Pharm Sci 2019; 32:1671-1677. [PMID: 31608889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The current research aims at development and assessment of o/w nystatin microemulsion. The pseudoternary phase diagrams were developed to determine microemulsion existence regions by water titration method. Nystatin was liquefied in the blend of oil phase, surfactant and cosurfactant. Microemulsion was made by deliberate mixing of water and stirring in this blend. The S-mix (surfactant-cosurfactant mixtures) of the ratio 1:2 was found better than 1:1 and 2:1 S-mix ratios. In vitro permeation studies by Franz diffusion cell revealed faster rate of nystatin release from such microemulsion (5.37μg/cm2/h) as compared to nystrin (4.79μg/cm2/h), a commercially available aqueous suspension. Kinetic modeling demonstrated zero order drug release and release mechanism found to be anomalous i.e. superposition of dispersion and swelling controlled drug release. Antifungal activity was performed using well diffusion method in vitro against Candida albicans cultures grown on Sabouraud's dextrose agar. The results also confirmed the high diffusion rate of drug from microemulsion as compared to aqueous suspension. The outcomes of this study propose that topical microemulsion of nystatin provides better antifungal activity as compared to emulsion gels or aqueous suspensions.
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Affiliation(s)
- Iram Maqsood
- Riphah International University, Faculty of Pharmacy, Lahore, Pakistan
| | - Muhammad Irfan Masood
- Institute of Pharmaceutical Sciences, Faculty of Biosciences, University of Veterinary & Animal Sciences, Lahore, Pakistan
| | - Hafiz Awais Nawaz
- Institute of Pharmaceutical Sciences, Faculty of Biosciences, University of Veterinary & Animal Sciences, Lahore, Pakistan
| | - Iram Shahzadi
- Institute of Pharmaceutical Sciences, Faculty of Biosciences, University of Veterinary & Animal Sciences, Lahore, Pakistan
| | - Naheed Arslan
- Jinnah Hospital Lahore, Hospital Pharmacist, Lahore, Pakistan
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Birkenbeuel J, Goshtasbi K, Mahboubi H, Djalilian HR. Recurrent apocrine hidrocystoma of the external auditory canal. Am J Otolaryngol 2019; 40:312-313. [PMID: 30717993 DOI: 10.1016/j.amjoto.2019.01.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Accepted: 01/28/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Jack Birkenbeuel
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, USA
| | - Khodayar Goshtasbi
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, USA
| | - Hossein Mahboubi
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, USA
| | - Hamid R Djalilian
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, USA; Department of Biomedical Engineering, University of California, Irvine, USA.
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El-Houssaini HH, Elnabawy OM, Nasser HA, Elkhatib WF. Influence of subinhibitory antifungal concentrations on extracellular hydrolases and biofilm production by Candida albicans recovered from Egyptian patients. BMC Infect Dis 2019; 19:54. [PMID: 30651066 PMCID: PMC6335770 DOI: 10.1186/s12879-019-3685-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 01/07/2019] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Extracellular hydrolases (phospholipase, aspartyl protease and haemolysin) and biofilm production are considered as major virulence factors of the opportunistic pathogenic fungus Candida albicans. However, the impact of antifungal therapy on such virulence attributes is not well investigated. The common antifungal agents may disturb the production of secreted hydrolases as well as biofilm formation. Accordingly, this study addressed the effect of subinhibitory concentrations (sub-MICs) of selected antifungal agents on some virulence factors of C. albicans clinical isolates. METHODS C. albicans isolates (n = 32) were recovered from different clinical samples and their identification was confirmed to the species level. Antifungal susceptibility profiles of isolates were determined against (nystatin, fluconazole and micafungin) and minimum inhibitory concentrations (MICs) were interpreted according to Clinical and Laboratory Standards Institute guidelines. Virulence determinants comprising secreted hydrolases (phospholipase, aspartyl protease and haemolysin) and biofilm formation were investigated in the presence of the sub-MICs of the tested antifungal agents. RESULTS Treatment of clinical C. albicans isolates with subinhibitory nystatin, fluconazole and micafungin concentrations significantly decreased production of extracellular hydrolases. Nystatin had the greatest inhibitory effect on phospholipase and aspartyl protease production. However, micafungin showed the highest reducing effect on the hemolytic activity of the treated clinical isolates. Moreover, nystatin and micafungin, but not fluconazole, had a noticeable significant impact on inhibiting biofilm formation of C. albicans clinical isolates. CONCLUSION Our findings highlighted the significant influences of commonly prescribed antifungal agents on some virulence factors of C. albicans. Accordingly, antifungal therapy may modulate key virulence attributes of C. albicans.
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Affiliation(s)
- Houdaii H. El-Houssaini
- Department of Microbiology and Public Health, Faculty of Pharmacy, Heliopolis University for Sustainable Development, 3 Cairo-Belbeis Road, El Horreya, Cairo, 11788 Egypt
| | - Omnia M. Elnabawy
- Department of Clinical Pathology, Faculty of Medicine, Ain Shams University, Abbassia square, Cairo, Egypt
| | - Hebatallah A. Nasser
- Department of Microbiology and Public Health, Faculty of Pharmacy, Heliopolis University for Sustainable Development, 3 Cairo-Belbeis Road, El Horreya, Cairo, 11788 Egypt
| | - Walid F. Elkhatib
- Department of Microbiology and Immunology, Faculty of Pharmacy, Ain Shams University, African Union Organization St., Abbassia, Cairo, 11566 Egypt
- Department of Microbiology and Immunology, School of Pharmacy and Pharmaceutical Industries, Badr University in Cairo (BUC), Entertainment Area, Badr City, Cairo, Egypt
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Ellepola ANB, Jayathilake JAMS, Sharma PN, Khan ZU. Impact of short-term exposure of antifungal agents on hemolysin activity of oral Candida dubliniensis isolates from Kuwait and Sri Lanka. J Investig Clin Dent 2016; 7:424-430. [PMID: 26059506 DOI: 10.1111/jicd.12167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2015] [Accepted: 05/16/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE Ability to produce hemolysin by Candida species is an important determinant of its pathogenicity. Candida dubliniensis is implicated in the causation of oral candidosis, which can be treated with polyene, echinocandin, and azole groups of antifungal agents as well as chlorhexidine. After oral application, however, the concentrations of these agents tend to decrease quickly to subtherapeutic levels due to the peculiarity of the oral environment. In this study, we have evaluated the effect of short-term exposure of sublethal concentrations of these drugs on hemolysin production by oral C. dubliniensis isolates obtained from two different geographical locale. MATERIALS AND METHODS Twenty C. dubliniensis oral isolates obtained from Kuwait and Sri Lanka were exposed to sublethal concentrations of nystatin, amphotericin B, caspofungin, ketoconazole, fluconazole, and chlorhexidine for 1 h. Thereafter, the drugs were removed by dilution and the hemolysin production determined by a previously described plate assay. RESULTS Hemolysin production of these isolates was significantly suppressed with a percentage reduction of 17.09, 16.45, 17.09, 11.39, 8.23 and 12.03 following exposure to nystatin, amphotericin B, caspofungin, ketoconazole, fluconazole, and chlorhexidine, respectively. CONCLUSION Brief exposure to sublethal concentrations of drugs with antifungal properties appears to reduce the pathogenic potential of C. dubliniensis isolates by suppressing hemolysin production.
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Affiliation(s)
- Arjuna N B Ellepola
- Faculty of Dentistry, Health Sciences Center, Kuwait University, Jabriya, Kuwait.
| | | | - Prem N Sharma
- Faculty of Medicine, Health Sciences Center, Kuwait University, Jabriya, Kuwait
| | - Zia U Khan
- Faculty of Medicine, Health Sciences Center, Kuwait University, Jabriya, Kuwait
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Abstract
Purpose. The objectives of this study were (1) to describe the usage of topical oral solutions in patients experiencing chemotherapy-induced oral mucositis (CIOM); and (2) to survey the care of oral mucositis provided to patients by clinical oncology pharmacists in institutional settings. Methods. Surveys were distributed to institutional pharmacists in the US, who were asked to provide the components of their ‘magic mouthwash’. Other questions included whether an institutional mucositis management guideline is available and what is the involvement of clinical pharmacy in mucositis care. Results. Forty institutions returned surveys during the study period. The top five ingredients used to compound the magic mouthwash are diphenhydramine, viscous lidocaine, magnesium hydroxide/aluminum hydroxide, nystatin and corticosteroids. Most institutions administer the mouthwash every 4 hours (36%) or every 6 hours (36%). Of the surveyed institutions, 33% currently possess guidelines for the management of CIOM. Conclusions. Most institutions in the country formulate their topical solution, or magic mouthwash, with a variety of ingredients. There is a need to standardize the ingredients used to compound the magic mouthwash, in order to fully evaluate the efficacy of the solution to manage CIOM.
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Affiliation(s)
- Alexandre Chan
- Department of Clinical Pharmacy, University of California, San Francisco, 94143-0622, USA.
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Vega F, Ramos T, Las Heras P, Blanco C. Concomitant sensitization to inhaled budesonide and oral nystatin presenting as allergic contact stomatitis and systemic allergic contact dermatitis. Cutis 2016; 97:24-27. [PMID: 26919353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Concomitant allergic reactions to multiple drugs are uncommon. We report the case of a 66-year-old woman who presented with concomitant sensitization to inhaled budesonide and oral nystatin presenting as allergic contact stomatitis and systemic allergic contact dermatitis. It is notable that one of the reactions was caused by oral nystatin, which generally is not considered to be allergenic due to its poor intestinal absorption. Diagnoses were confirmed on patch testing with histologic examination along with oral challenge testing. We also used challenge testing to rule out cross-reactivity among nystatin and other macrolide drugs, both antifungals and antibiotics.
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Affiliation(s)
- Francisco Vega
- Department of Allergy, Instituto de Investigación Sanitaria Princesa, Hospital Universitario de la Princesa, Madrid, Spain
| | - Tania Ramos
- From the Department of Allergy, Instituto de Investigación Sanitaria Princesa, Hospital Universitario de la Princesa, Madrid, Spain
| | - Paloma Las Heras
- From the Department of Allergy, Instituto de Investigación Sanitaria Princesa, Hospital Universitario de la Princesa, Madrid, Spain
| | - Carlos Blanco
- From the Department of Allergy, Instituto de Investigación Sanitaria Princesa, Hospital Universitario de la Princesa, Madrid, Spain
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Rivarola de Gutierrez E, Di Fabio A, Salomón S, Lanfranchi H. Topical treatment of oral lichen planus with anthocyanins. Med Oral Patol Oral Cir Bucal 2014; 19:e459-66. [PMID: 24880442 PMCID: PMC4192568 DOI: 10.4317/medoral.19472] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Accepted: 12/02/2013] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Oxidative stress is involved in oral lichen planus (OLP) pathogenesis; meanwhile anthocyanins are natural antioxidants present in grapes skin. OBJECTIVES The aim of this research was to verify the utility of anthocyanins, extracted from grapes skin, for the local treatment of oral lichen planus and to compare it with clobetasol propionate- neomycin -nystatin cream (CP-NN). STUDY DESIGN Prospective, non-randomized study, with control group. Fifty-two patients with OLP were included. We divided patients into two categories: erosive oral lichen planus (EOLP) and non erosive oral lichen planus (NEOLP). 38 had EOLP (17 cases and 21 controls) and 14 presented NEOLP types (9 cases and 5 controls).Cases received local treatment with anthocyanins from grapes and controls, were treated with CP-NN. The clinical evolution of patients was followed up during six months. RESULTS The patients had a therapeutic response with anthocyanins. This was better than CP-NN treatment for patients with EOLP, in improving the involvement score of the oral mucosa and in the morphometric study of the affected areas. In EOLP there were no statistically significant differences in: therapeutic response time, the evolution of pain, or the relapse rate between the two groups. With respect to the treatment of NEOLP there was improved pain relief in the group treated with anthocyanins. This was not observed with CP-NN. The resting analized variables showed no significant difference with both treatments. CONCLUSIONS OLP has a favorable response to local treatment with anthocyanins from grapes. We found an equal to or better response than with CP-NN treatment. Many of our patients have systemic diseases, which may contraindicate the use of steroids. With regard to this particular group, the use of this natural antioxidant present in the diet is considered advantageous.
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Sklenár Z, Scigel V, Horácková K, Slanar O. Compounded preparations with nystatin for oral and oromucosal administration. Acta Pol Pharm 2013; 70:759-762. [PMID: 23923400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Therapy of oral, esophageal and gastrointestinal candidiasis is still a common problem that can be solved by an administration of antimycotics. Major disadvantage of registered commercial antifungal medicinal products is their price, so the health care system and its payers may profit from extemporaneous compounding. An appropriate drug therapy for candidiasis (trush) is nystatin, which is a substance available in the Czech Republic for the magistral preparation relatively recently, since 2010. Making formulas for extemporaneous compounding is quite simple and preparations particularly useful for dentists, pediatricians, otolaryngologists, oncologists and gastroenterologists. The authors formulated composition of viscous oromucosal suspension, oral/oromucosal hydrogel and oromucosal gelatine globule which may be present as compounded products containing nystatin for oromucosal and/or oral administration. The preparation is practically verified and magistral products have been already used in clinical practice.
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Affiliation(s)
- Zbynek Sklenár
- Charles University in Prague, First Faculty of Medicine, Institute of Pharmacology, Albertov 4, 128 00 Prague 2, Czech Republic.
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Stoopler ET. Management of oral chronic graft-versus-host disease. J Can Dent Assoc 2013; 79:d37. [PMID: 23763728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Noss MR, Cha J. Erythematous penile lesion. J Fam Pract 2012; 61:753-755. [PMID: 23313994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Previous efforts to diagnose the cause of this patient's rash had been unsuccessful. A biopsy confirmed our suspicions.
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Affiliation(s)
- Matthew R Noss
- Family Medicine Residency, Fort Belvoir Community Hospital, Fort Belvoir, VA 22060, USA.
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Polish Gynecological Society Expert Group. [Statement of the Polish Gynecological Society Expert Group on the use of Macmiror Complex 500]. Ginekol Pol 2012; 83:956-9. [PMID: 23488303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
The group of experts representing the Polish Gynecologic Society has issued this statement based on the review of available literature on the potential benefits of the use of Macmiror Complex 500 in obstetrical and gynecologic practice. Mixed Vaginitis (MV) eg. the vaginal infection caused by at least two out of the triad of pathogens (fungi, bacteria and Trichomonas Vaginalis [TV]), constitutes the type of vaginitis which is underestimated as for its prevalence. Mixed pathogens are responsible for as much as one third of all vaginal infections. Macmiror Complex 500 contains two active ingredients: nifuratel and nystatin. Macmiror Complex 500 affects all common causes of vulvovaginitis, i.e. bacteria, yeasts and TV. At the same time, it is not effective against Lactobacillus spp., which is a clear advantage in the treatment of vaginal infections. The antibacterial spectrum of nifuratel includes aerobic and anaerobic bacteria. Moreover nifuratel is effective against Chlamydia trachomatis and Mycoplasma spp., it has an anti-trichomonal effect comparable to metranidazole and shows certain activity against Candida spp. Nystatin is effective against Candida albicans and is even very effective against Candida glabrata which is usually more resistant to imidazole antifungal agents. Nystatin's importance is rising due to the current increase of candidoses caused by non-albicans types. This increase is especially perceptible in recurring candidoses. The review of the available literature on the effectiveness of Macmiror Complex 500 in the OB/GYN practice leads to the following conclusions: the exeptionally broad antibacterial and antifungal and trichomonicidal activity of this formulation makes it a drug of choice in cases where MV is suspected. The possibility to treat both partners, favorable safety profile in pregnant patients and the availability of both vaginal ovules and the cream with applicator makes this drug an effective and suitable treatment option in obstetrical and gynecologic practice.
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Sanita PV, Machado AL, Pavarina AC, Massucato EMS, Colombo AL, Vergani CE. Microwave denture disinfection versus nystatin in treating patients with well-controlled type 2 diabetes and denture stomatitis: a randomized clinical trial. INT J PROSTHODONT 2012; 25:232-244. [PMID: 22545252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
PURPOSE The aim of this randomized clinical trial was to compare the effectiveness of microwave denture disinfection and nystatin in the treatment of well-controlled type 2 diabetic patients with denture stomatitis in terms of microbiologic and clinical outcomes. MATERIALS AND METHOD Diabetic patients wearing maxillary complete dentures with denture stomatitis (n = 40) were divided into two groups: NYS (patients treated with topical nystatin 4 times/day for 14 days) and MW (patients who had their dentures microwaved [650 W for 3 minutes] 3 times/week for 14 days). Mycologic samples were taken from the palates and dentures of the patients for quantification and identification of Candida, and standardized photographs of the palates were taken for clinical analysis. Evaluations were repeated at baseline, the end of treatment (day 14), and throughout follow-up (days 30, 60, and 90). Microbiologic data were evaluated by analysis of variance using a random effects statistical model, Tukey post hoc test, and chi-square test (α = .05). Clinical results were analyzed using Mann-Whitney and Fisher exact tests (α = .05). RESULTS Both treatments were considered successful in reducing the clinical signs of denture stomatitis and significantly reduced the values of colony-forming units/mL from the palates and dentures at days 14 and 30. In addition, 40% of treated patients were cured by the end of treatment. No significant differences in the microbiologic and clinical outcomes were revealed between the two groups (P > .05). C albicans was the most predominant species isolated (P < .01), followed by C tropicalis and C glabrata. CONCLUSION Denture microwave disinfection was as effective as nystatin for the treatment of diabetic patients with denture stomatitis.
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MESH Headings
- Administration, Topical
- Aged
- Analysis of Variance
- Antifungal Agents/administration & dosage
- Antifungal Agents/therapeutic use
- Candida/isolation & purification
- Chi-Square Distribution
- Colony Count, Microbial
- Denture, Complete/adverse effects
- Denture, Complete/microbiology
- Diabetes Mellitus, Type 2/complications
- Disinfection/methods
- Female
- Humans
- Likelihood Functions
- Male
- Microwaves
- Middle Aged
- Nystatin/administration & dosage
- Nystatin/therapeutic use
- Palate, Hard/microbiology
- Single-Blind Method
- Stomatitis, Denture/complications
- Stomatitis, Denture/etiology
- Stomatitis, Denture/microbiology
- Stomatitis, Denture/therapy
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Abstract
Vaginally applied antimicrobial agents are widely used in the vagina in women with lower genital tract infections. An 'antimicrobial' is a general term that refers to a group of drugs that are effective against bacteria, fungi, viruses and protozoa. Topical treatments can be prescribed for a wide variety of vaginal infections. Many bacterial infections, such as bacterial vaginosis, desquamative inflammatory vaginitis or, as some European authors call it, aerobic vaginitis as well as infection with Staphylococcus aureus or group A streptococci, may be treated in this way. Candida vulvovaginitis is a fungal infection that is very amenable to topical treatment. The most common viral infections which can be treated with topical medications are condylomata acuminata and herpes simplex. The most often encountered protozoal vaginitis, which is caused by Trichomonas vaginalis, may be susceptible to topical medications, although this infection is treated systemically. This chapter covers the wide variety of commonly used topical antimicrobial agents for these diseases and focuses on the individual therapeutic agents and their clinical efficacy. In addition, potential difficulties that can occur in practice, as well as the usage of these medications in the special setting of pregnancy, are described in this chapter.
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Tempark T, Phatarakijnirund V, Chatproedprai S, Watcharasindhu S, Supornsilchai V, Wananukul S. Exogenous Cushing's syndrome due to topical corticosteroid application: case report and review literature. Endocrine 2010; 38:328-34. [PMID: 20972726 DOI: 10.1007/s12020-010-9393-6] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2010] [Accepted: 08/24/2010] [Indexed: 11/30/2022]
Abstract
Prolonged use of topical corticosteroids causes systemic adverse effects including Cushing's syndrome and hypothalamic-pituitary-adrenal (HPA) axis suppression, which is less common than that of the oral or parenteral route. At least 43 cases with iatrogenic Cushing syndrome from very potent topical steroid usage (Clobetasol) in children and adult have been published over the last 35 years particularly in developing countries. In children group (n = 22), most are infants with diaper dermatitis and two cases who had started topical application at a very early age and died from severe disseminated CMV infection. For the adult group (n = 21), the most common purpose of steroid use was for treatment of Psoriasis. The recovery period of HPA axis suppression was 3.49 ± 2.92 and 3.84 ± 2.51 months in children and adult, respectively. We report on an 8-month-old female infant who developed Cushing's syndrome and adrenal insufficiency after diaper dermatitis treatment through the misuse of Clobetasol without doctor's prescription. Physiologic dose of hydrocortisone was prescribed to prevent an adrenal crisis for 3 months and discontinued when HPA axis recovery was confirmed by normal morning cortisol and ACTH levels.
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Affiliation(s)
- Therdpong Tempark
- Division of Dermatology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
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Jahić M, Balić A, Nurkić M, Dragović J, Adzajlić A, Habibović A, Mesalić L, Zigić A. [Local combined therapy of vaginal infections by nifuratel-nistatin]. Med Glas (Zenica) 2010; 7:86-88. [PMID: 20387731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
A test included 40 women in the reproductive age with clinical symptoms of vaginitis and microbiological examination. They were treated by combined therapy of vaginal tablets of nifuratel, 500 mg and nistatin 200 000 i. u. during six days, after which they underwent gynaecological reexamination and repeated microbiological examination of vaginal and cervical smears. An analiysis of vaginal secretion found bacterial flora in 34 smears (65%), fungus (Candida albicans) in 15 (24%) and Trichomonas vaginalis in 7 (11%). Local vaginal therapy in vaginitis caused by Trichomonas vaginalis was successfull in all 7 patients, vaginitis caused by Candida albicans was successly treated in 14 (93%) patients. Bacterial vaginitis was cured in 29 (71%) patients during this tharapy. Local vaginal combined therapy of nifuratel and nistatin is eficient in patients with vaginitis caused by fungi and Trichomonas vaginalis too.
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Affiliation(s)
- Mahira Jahić
- Sluzba za zdravstvenu zastitu zena, Dom zdravlja Tuzla s poliklinikom z'Dr. Mustafa Sehović", Tuzla, Bosna i Hercegovina.
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Chandran SK, Lyons KM, Divi V, Geyer M, Sataloff RT. Fungal laryngitis. Ear Nose Throat J 2009; 88:1026-1027. [PMID: 19688709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Affiliation(s)
- Swapna K Chandran
- Department of Otolaryngology-Head and Neck Surgery, Drexel University College of Medicine, Philadelphia, PA, USA
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de la Borbolla JM, Goikoetxea MJ, Cabrera-Freitag P, Gastaminza G. Late reaction to oral nystatin: the importance of patch testing. J Investig Allergol Clin Immunol 2009; 19:321-322. [PMID: 19639730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Affiliation(s)
- J M de la Borbolla
- Department of Allergology and Clinical Immunology, University Clinic of Navarra, Pamplona, Spain.
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24
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Milánkovits M. [Vaginal infections associated with bacterial vaginosis and periodontal disease--effective diagnostic and therapeutic possibilities]. Orv Hetil 2008; 149:2149-51. [PMID: 18977743 DOI: 10.1556/oh.2008.45l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Su CW, Gaskie S, Jamieson B, Triezenberg D. Clinical inquiries. What is the best treatment for oral thrush in healthy infants? J Fam Pract 2008; 57:484-485. [PMID: 18625176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Affiliation(s)
- Cindy W Su
- Santa Rosa Family Medicine Residency Program, Santa Rosa, CA, USA
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[Macmiror, Macmiror Complex--combined antimicrobial preparation for the treatment of vulvo-vaginal infection]. Akush Ginekol (Sofiia) 2008; 47:55. [PMID: 18642589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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Llabot JM, Allemandi DA, Manzo RH, Longhi MR. HPLC method for the determination of nystatin in saliva for application in clinical studies. J Pharm Biomed Anal 2007; 45:526-30. [PMID: 17658236 DOI: 10.1016/j.jpba.2007.06.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2007] [Revised: 04/16/2007] [Accepted: 06/13/2007] [Indexed: 11/18/2022]
Abstract
An isocratic high-performance liquid chromatographic method was developed, optimized and validated for the determination of nystatin in human saliva (UV and fluorescence detection). A reversed-phase Luna C18 column (25 degrees C), with a mobile phase of MeOH, H2O, and DMF (70:20:10, v/v/v), and a flow-rate of 0.8 ml/min were used. The elution time for nystatin was 5.8+/-0.2 min. Calibration curves in human saliva were linear from 0.78 to 50 microg/ml. Limits of quantification were 0.78 microg/ml and 0.75 microg/ml for UV and fluorescence detection, respectively. The accuracy and precision values of intra- and inter-day variation studies were within acceptable limits, according to FDA guidelines. The described method has proved to be useful to give accurate measurements of nystatin in real samples.
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Affiliation(s)
- Juan M Llabot
- Departamento de Farmacia, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Ciudad Universitaria, 5000 Córdoba, Argentina
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Llabot JM, Palma SD, Manzo RH, Allemandi DA. Design of novel antifungal mucoadhesive films. Int J Pharm 2007; 336:263-8. [PMID: 17223291 DOI: 10.1016/j.ijpharm.2006.12.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2006] [Revised: 11/30/2006] [Accepted: 12/03/2006] [Indexed: 10/23/2022]
Abstract
This paper deals with the formulation of the mucoadhesive films containing nystatin. The design and formulation of the films were based on the mucoadhesive properties of carbomer 934P (CB) and carboxymethycellulose (NaCMC), and also on the plasticizer properties of polyethyleneglycol 400 (PEG400). A surfactant (ascorbyl palmitate, ASC16) was added to the system to aid in nystatin dispersion. Addition of these last two components produced a significant improvement in physical-mechanical properties (flexibility and strength) as well as an increase in the nystatin release rate. X-ray powder diffraction (XRPD) and scanning electronic microscopy (SEM) were used to evaluate the morphological changes in the films while PEG400 and ASC16 were added to the formulations. Furthermore, the in vitro nystatin profile release was determined.
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Affiliation(s)
- J M Llabot
- Departamento de Farmacia, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, 5000 Córdoba, Argentina
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Llabot JM, Palma SD, Manzo RH, Allemandi DA. Design of novel antifungal mucoadhesive films. Int J Pharm 2007; 330:54-60. [PMID: 17071026 DOI: 10.1016/j.ijpharm.2006.08.042] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2006] [Revised: 08/24/2006] [Accepted: 08/28/2006] [Indexed: 10/24/2022]
Abstract
In this work, pre-formulation studies concerning the design of novel mucoadhesive films have been carried out. The rationality of the design is based on the utilization of mucoadhesive polymers (carbomer and carboxymethylcellulose), a plasticizer (polyethyleneglycol 400, PEG400) and a surfactant (ascorbyl palmitate, ASC16). In the gel preparation, the casting method using water as a solvent was employed. To provide a better understanding of the structural arrangements produced during the casting process, the changes in morphology (Cryo-TEM) and rheology (viscosity) of the film forming gel were evaluated. When PEG400 was included as a plasticizer, a disorder was produced in the network, reflected in the globular structure adopted by the gel and the consequent decrease in viscosity. The addition of ASC16 improved the solubilization of nystatin and provoked a decrease in gel viscosity. However, as water was removed during casting, ASC16 produced a significant increase in the viscosity at the point in which the polymer concentrations were sufficient to strengthen the inter-polymeric interactions, giving rise to a more rigid tri-dimensional network.
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Affiliation(s)
- J M Llabot
- Departamento de Farmacia, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, 5000 Córdoba, Argentina
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[Macmiror complex]. Akush Ginekol (Sofiia) 2007; 46:57-8. [PMID: 17974185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
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Khristamian A. [Conservative treatment of women with genital HPV. Results of Polygynax and Pharmatex combination]. Akush Ginekol (Sofiia) 2007; 46 Suppl 2:22-28. [PMID: 18217302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
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Scheuch E, Giessmann T, Siegmund W. Quantitative determination of nystatin in human plasma using LC–MS after inhalative administration in healthy subjects. J Chromatogr B Analyt Technol Biomed Life Sci 2006; 844:84-8. [PMID: 16890501 DOI: 10.1016/j.jchromb.2006.07.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2006] [Revised: 06/02/2006] [Accepted: 07/02/2006] [Indexed: 11/24/2022]
Abstract
The antifungal polyene antibiotics nystatin was tested in a clinical trial to describe pharmacokinetics and safety after repeated administration of Nystatin "Lederle" sterile powder in healthy volunteers. To monitor the nystatin concentration-time profile in plasma we developed a sensitive method in the range of 1-100ng/ml based on liquid chromatography coupled with tandem mass spectrometry. The target substance was separated from the biological matrix on C(18) solid-phase extraction cartridges with methanol. The Chromatography was performed isocratically using a reversed phase Caltrex Resorcinearene column. The mobile phase consisted of 5mM ammonium formate buffer and acetonitrile (40:60, v/v). The mass spectrometer works with electrospray ionization in its positive selected ion monitoring (SIM) mode using the respective MH(+) ions, m/z 926.6 for nystatin and m/z 924.4 for amphotericin B as internal standard. The method validation was performed according to the demands and international criteria for validation of bioanalytical methods and was successfully applied to the quantification of nystatin in human plasma in the pharmacokinetic trial.
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Affiliation(s)
- Eberhard Scheuch
- Department of Clinical Pharmacology, Research Centre of Pharmacology and Experimental Therapeutics, University of Greifswald, Friedrich-Loeffler-Str. 23d, D-17487 Greifswald, Germany.
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Abstract
The use of oral nystatin to prevent fungal colonisation and infection in neonates in the Neonatal Intensive Care Unit (NICU) is still an open question and not yet recommended as a standard of care. To determine whether prophylactic oral nystatin results in a decreased incidence of invasive candidiasis in the newborn infants, a total of 3991 infants were divided randomly into two groups. Group A infants (n = 1995), only those neonates who were identified as yeast carriers (oral moniliasis) were treated with oral nystatin. Group B infants, all neonates who were admitted to the unit received oral nystatin, was routinely administered three times a day. Group A was divided into groups A1 and A2 (who were treated only if identified as yeast carriers). Urine and rectal cultures were taken on admission and then weekly thereafter. There were 215 (14.2%), 27 (5.6%) and 36 (1.8%) patients positive for invasive candidiasis in groups A1, A2 and B respectively. Oral nystatin prophylaxis significantly reduced the invasive candidiasis (P = 0.004) in extremely low-birth weight (ELBW) and very low-birth weight (VLBW) infants. Prophylactic administration of oral nystatine to the ELBW and VLBW infants results in a decreased risk of invasive candidiasis.
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Affiliation(s)
- Mehmet Adnan Ozturk
- Department of Paediatrics, Division of Neonatology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
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Tallury P, Randall MK, Thaw KL, Preisser JS, Kalachandra S. Effects of solubilizing surfactants and loading of antiviral, antimicrobial, and antifungal drugs on their release rates from ethylene vinyl acetate copolymer. Dent Mater 2006; 23:977-82. [PMID: 17049593 PMCID: PMC3881552 DOI: 10.1016/j.dental.2006.08.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2006] [Revised: 08/21/2006] [Accepted: 08/31/2006] [Indexed: 12/01/2022]
Abstract
OBJECTIVES This study investigates the effects of surfactants and drug loading on the drug release rate from ethylene vinyl acetate (EVA) copolymer. The release rate of nystatin from EVA was studied with addition of non-ionic surfactants Tween 60 and Cremophor RH 40. In addition, the effect of increasing drug load on the release rates of nystatin, chlorhexidine diacetate and acyclovir is also presented. METHOD Polymer casting solutions were prepared by stirring EVA copolymer and nystatin (2.5wt.%) in dichloromethane. Nystatin and surfactants were added in ratios of (1:1), (1:2) and (1:3). Drug loading was studied with 2.5, 5.0, 7.5, and 10.0wt.% proportions of nystatin, chlorhexidine diacetate and acyclovir incorporated into a separate polymer. Three drug loaded polymer square films (3cmx3cmx0.08cm) were cut from dry films to follow the kinetics of drug release at 37 degrees C. Ten milliliters of either distilled water or PBS was used as the extracting medium that was replaced daily. PBS was used for nystatin release with addition of surfactants and water was used for the study on drug loading and surfactant release. The rate of drug release was measured by UV-spectrophotometer. The amount of surfactant released was determined by HPLC. RESULTS The release of nystatin was low in PBS and its release rate increased with the addition of surfactants. Also, increasing surfactant concentrations resulted in increased drug release rates. The release rates of chlorhexidine diacetate (p<0.0001), acyclovir (p<0.0003) and nystatin (p<0.0017) linearly increased with increasing drug loads. The amount of surfactants released was above the CMC. SIGNIFICANCE This study demonstrates that the three therapeutic agents show a sustained rate of drug release from EVA copolymer over extended periods of time. Nystatin release in PBS is low owing to its poor solubility. Its release rate is enhanced by addition of surfactants and increasing the drug load as well.
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Affiliation(s)
- Padmavathy Tallury
- Center for Oral and Systemic Diseases, Department of Periodontology, School of Dentistry, University of North Carolina, Chapel Hill, NC 27599-7455, USA
| | - Marcus K Randall
- Center for Oral and Systemic Diseases, Department of Periodontology, School of Dentistry, University of North Carolina, Chapel Hill, NC 27599-7455, USA
| | - Khin L Thaw
- Center for Oral and Systemic Diseases, Department of Periodontology, School of Dentistry, University of North Carolina, Chapel Hill, NC 27599-7455, USA
| | - John S. Preisser
- Department of Biostatistics, School of Public Health, University of North Carolina, Chapel Hill, NC 27599-7455, USA
| | - Sid Kalachandra
- Center for Oral and Systemic Diseases, Department of Periodontology, School of Dentistry, University of North Carolina, Chapel Hill, NC 27599-7455, USA
- Corresponding Author Tel : +1-919-966-4545; Fax : +1-919-966-7537 (S.Kalachandra)
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Prieto Santa Anna LM, Illnait Zaragozi MT, Ramos Rodallegas EG, Lazcano Herrero B, Márquez Sánchez N, Cantelar de Francisco N, Manzur Katriba J, Martínez Machin G. [Oral candidiasis in HIV-seropositive patients and AIDS cases. Clinical, mycological and therapeutical aspects]. Rev Cubana Med Trop 2006; 58:173-180. [PMID: 23424783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
A prospective study to identify clinical and mycological aspects of oral candidiasis including a therapeutic trial for 4 drugs-2 topical (chlotrimazole and nistatine) and 2 systemic (itraconale and ketoconazole) was performed on 97 HIV adult patients from March 2003 to June 2004. Average age was 34.97 years, being males and heterosexual behaviour predominant. The pseudomembranous clinical form of presentation prevailed in 93.8% of cases, with accompanying symptoms like pain, burning sensation and difficult swallowing in addition to extensive lesions. Candida albicans was the most frequently isolated species both in swabs taken at the beginning (92%) and at the end of the treatment schedules applied to patients who did not succeed in mycological cure (89.4%). Treatment schemes had positive results from the clinical viewpoint in 91.8% of cases with improvement or total remission of symptoms and signs, and in 51.6% of mycological curing. There were no statistically significant differences of clinical and mycological responses between topical and systemic treatments. The above-mentioned allowed recommending a more extensive use of local treatment in the studied population because of their benefits for the patients.
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Urban VM, de Souza RF, Arrais CAG, Borsato KT, Vaz LG. Effect of the Association of Nystatin with a Tissue Conditioner on its Ultimate Tensile Strength. J Prosthodont 2006; 15:295-9. [PMID: 16958730 DOI: 10.1111/j.1532-849x.2006.00130.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
PURPOSE This study evaluated the ultimate tensile strength of a tissue conditioner without nystatin incorporation (GI-control group) and the same tissue conditioner modified by the addition of nystatin in two concentrations: GII-500,000 International Units (U) and GIII-1,000,000 U, in which each milligram of the medicament corresponded to 6079 U. MATERIALS AND METHODS Dumbbell-shaped specimens (N= 7) with a central cross-sectional area of 33 x 6 x 3 mm were produced for the three experimental groups. After polymerization following manufacturer's instructions, specimens were immersed in distilled water at 37 degrees C for either 24 hours or 7 days and then tested in tension in the MTS 810 at 40 mm/minute. Data were analyzed by two-way ANOVA followed by Tukey's test, at 95% level of confidence. RESULTS The means (force-grams (gf) +/- standard deviation) of the ultimate tensile strength were: GI-634.29 +/- 122.80; GII-561.92 +/- 133.56; and GIII-547.30 +/- 73.47 for 24-hour storage, and GI-536.68 +/- 54.71; GII-467.50 +/- 143.51; and GIII-500.62 +/- 159.76 for 7-day storage. There were no statistically significant differences among the three experimental groups (p > 0.05). The ultimate tensile strength means of all experimental groups after 7 days were significantly lower than those observed after 24 hours (p= 0.04). CONCLUSIONS The results of this study suggest that the addition of nystatin into the tissue conditioner investigated in concentrations below 1,000,000 U did not affect its ultimate tensile strength.
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Affiliation(s)
- Vanessa Migliorini Urban
- Department of Dental Materials and Prosthodontics, Araraquara Dental School, São Paulo State University, Araraquara, São Paulo, Brazil.
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Pavlović MD, Bulajić N. Great toenail onychomycosis caused by Syncephalastrum racemosum. Dermatol Online J 2006; 12:7. [PMID: 16638375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2023] Open
Abstract
Nondermatophyte molds are fungi found in soil and decaying plant debris and are generally considered to be uncommon or secondary pathogens of diseased nails. Prevalence rates of onychomycoses caused by nondermatophyte molds range between 1.45 percent and 17.60 percent. The most common nondermatophyte molds associated with nail disease are Scopulariopsis, Scytalidium, Fusarium, Aspergillus and Onychocola canadensis. Syncephalastrum racemosum, a nondermatophyte mold, belongs to the class Zygomycetae. Only one well-documented case of human disease attributed to this organism has been described. We describe a 45-year-old man with culture proven toenail onychomycosis due to Syncephalstrum racemosum.
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Affiliation(s)
- Milos D Pavlović
- Department of Dermatology, Military Medical Academy, Belgrade, Serbia and Montenegro.
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Nasti TH, Khan MA, Owais M. Enhanced efficacy of pH-sensitive nystatin liposomes against Cryptococcus neoformans in murine model. J Antimicrob Chemother 2005; 57:349-52. [PMID: 16368700 DOI: 10.1093/jac/dki454] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES To evaluate the efficacy of pH-sensitive liposomes of nystatin against Cryptococcus neoformans infection in a murine model. METHODS In the present study, we investigated the antifungal activity of nystatin entrapped in pH-sensitive liposomes in a murine model. Mice infected with C. neoformans were treated with nystatin in neutral egg phosphatidylcholine (egg-PC) liposomes, as well as pH-sensitive nystatin liposomes. The anticryptococcal efficacy of liposomal formulations of nystatin was assessed by continued survival and colony-forming units (cfu) in liver and brain of the treated mice. RESULTS pH-sensitive liposomes of nystatin showed better efficacy compared with its free or egg-PC liposome form against C. neoformans infection in BALB/c mice. Mice treated with pH-sensitive nystatin liposomes showed 80% survival with less fungal burden in liver and brain of treated mice. However, there was only 40% survival in the group of animals treated with egg-PC liposome-intercalated nystatin, whereas its free form had poor efficacy with 20% survival. CONCLUSIONS The enhanced anticryptococcal efficacy of the pH-sensitive nystatin liposomes can be attributed to the pH-dependent release of the drug in the low pH environment of lysosomes. The destabilization of the pH-sensitive liposomes in the acidic environment of macrophages results in the site-specific targeting of nystatin that improves its intracellular antifungal activity.
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Affiliation(s)
- Tahseen H Nasti
- Interdisciplinary Biotechnology Unit, Aligarh Muslim University, Aligarh 202002, India
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Student nurse gives antibiotic i.v.--death results. Dennis v. Specialty Select Hospital-Flint, 2005 WL 2402454 N.W.2d -MI. Nurs Law Regan Rep 2005; 46:1. [PMID: 16312112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
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Normand S, François B, Dardé ML, Bouteille B, Bonnivard M, Preux PM, Gastinne H, Vignon P. Oral nystatin prophylaxis of Candida spp. colonization in ventilated critically ill patients. Intensive Care Med 2005; 31:1508-13. [PMID: 16195905 DOI: 10.1007/s00134-005-2807-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2005] [Accepted: 07/29/2005] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Colonization of multiple body sites is a leading risk factor for Candida spp. infection in intensive care unit (ICU) patients. We evaluated whether oral nystatin prophylaxis reduces Candida spp. colonization in ventilated ICU patients. DESIGN AND SETTING Prospective, randomized, open-label study with blinded assessment of the objective primary evaluation criterion in the medical-surgical ICU of a teaching hospital. PATIENTS The study included 98 consecutive patients mechanically ventilated for at least 48 h (mean age 58+/-19 years; mean SAPS II 40+/-11), assigned to either treatment group (n=51) or control group (n=47). Study groups were comparable for age, SAPS II, reason for admission, and immune status. INTERVENTIONS Patients were randomized to receive oral nystatin (treatment group; 3x10(6) U per day) or no nystatin (control group). Multiple body sites (trachea, stomach, rectum, urine, groin, and blood) were tested for Candida spp. on admission and then every 3 days by mycologists blinded to group assignment, and the colonization index was determined. RESULTS Colonization by Candida spp. developed in 25% of controls but in none of the treated patients. In multivariate analysis, the absence of nystatin prophylaxis and ICU length of stay were independently associated with Candida spp. colonization. No invasive candidiasis was diagnosed in either study group. CONCLUSIONS Oral nystatin prophylaxis efficiently prevented Candida spp. colonization in ICU patients at low risk of developing invasive candidiasis. Further studies are needed to determine whether this strategy remains efficient in reducing Candida spp. infections in higher risk ICU patients.
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Affiliation(s)
- Sandrine Normand
- Medical-Surgical ICU, Dupuytren Teaching Hospital, 2 Ave. Martin Luther King, 87042, Limoges Cedex, France
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Eggimann P, Wolff M, Garbino J. Oral nystatin as antifungal prophylaxis in critically ill patients: an old SDD tool to be renewed? Intensive Care Med 2005; 31:1466-8. [PMID: 16195906 DOI: 10.1007/s00134-005-2806-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2005] [Accepted: 08/29/2005] [Indexed: 10/25/2022]
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Affiliation(s)
- Scott M Phillips
- Department of Care Planning and Restorative Sciences, School of Dentistry, University of Mississippi Medical Center, Jackson, MS 39216-4505, USA.
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Kocak Z, Hatipoglu CA, Ertem G, Kinikli S, Tufan A, Irmak H, Demiroz AP. Trimethoprim-sulfamethoxazole induced rash and fatal hematologic disorders. J Infect 2005; 52:e49-52. [PMID: 15996741 DOI: 10.1016/j.jinf.2005.05.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2005] [Accepted: 05/11/2005] [Indexed: 11/27/2022]
Abstract
Trimethoprim-sulfamethoxazole (TMP-SMX) is a combination chemotherapeutic agent, a commonly used antibiotic. Adverse drug reactions occur in 6-8% of patients. Although, the most common adverse reactions include mild gastrointestinal distress and cutaneous events, also a wide range of hematological abnormalities have been ascribed to TMP-SMX. We report a 40-year-old male patient who developed an early onset neutropenia, thrombocytopenia, generalised rash and oral candidiasis after 5 days long TMP-SMX therapy. Although generalised rash may seen more and improves with discontinuation of the therapy; severe neutropenia, thrombocytopenia and oral candidiasis are seen very rare and rarely leads to fatality as it was in our case. Despite thrombocyte transfusions, whole blood transfusions, red cell concentrates and filgrastim therapy we lost our patient. We want to underline that although the TMP-SMX combination is usually well tolerated it can also lead to fatal complications.
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Affiliation(s)
- Zeliha Kocak
- Infectious Diseases and Clinical Microbiology Department, Ministry of Health Ankara Research and Training Hospital, Ankara, Turkey.
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Cepický P, Malina J, Líbalová Z, Kuzelová M. ["Mixed" and "miscellaneous" vulvovaginitis: diagnostics and therapy of vaginal administration of nystatin and nifuratel]. Ceska Gynekol 2005; 70:232-7. [PMID: 16047929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
AIM OF THE STUDY The evaluation of combined and miscellaneous vulvovaginal infections incidence and their treatment with combined vaginal products containing nifuratel and nystatin. DESIGN Prospective study. SETTING Gynecologic outpatient department LEVRET, Prague; Laboratories of Microbiology AescuLab, Prague. METHODS 70 consecutive patients were examined with complaint of vaginal fluor and/or pruritus. We established macroscopic features of fluor, pH, amine test and mounts stained with Giemsa and Gram. We qualified the cases with more diagnostic criteria (mycosis, lactobacillosis, anaerobic vaginosis, aerobic vaginitis) as combined infection, those with no diagnostic criteria as miscellaneous. We treated all patients with vaginal tablets nystatin + nifuratel (Macmiror complex). We prescribed clotrimazol cream, if pruritus was present. We evaluated withdrawals of symptoms and relapses during 3 months after treatment. RESULTS Combined infection was found in 21 patients from 70 (30%). The most frequent combination was that of mycosis and aerobic vaginitis (13/70, 18.6%) or mycosis and anaerobic vaginosis (4/70, 5.7%); 11 patients fulfilled criteria of no diagnosis. We concluded them as "miscelaneous". The treatment was successful in all cases, 10 women relapsed in 3 months. CONCLUSIONS Combined vaginal infection findings are present very often (30%), likewise miscellaneous ones (15%) occur. The treatment of these women in successful with vaginal tablets with nystatin + nifuratel.
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Affiliation(s)
- P Cepický
- Gynekologicko-porodnická ambulance LEVRET s.r.o., Praha
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Aksungur P, Sungur A, Unal S, Iskit AB, Squier CA, Senel S. Chitosan delivery systems for the treatment of oral mucositis: in vitro and in vivo studies. J Control Release 2005; 98:269-79. [PMID: 15262418 DOI: 10.1016/j.jconrel.2004.05.002] [Citation(s) in RCA: 125] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2004] [Accepted: 05/05/2004] [Indexed: 11/15/2022]
Abstract
Oral mucositis is a frequent and potentially severe complication of radiation or chemotherapy for cancer. Associated with atrophy and ulceration of the oral mucosa is an increased risk of infection, and the most common pathogenic agent is Candida. Chitosan is an excellent candidate for the treatment of oral mucositis. Its bioadhesive and antimicrobial properties offer the palliative effects of an occlusive dressing and the potential for delivering drugs, including anti-candidal agents. The aim of this study was to develop an occlusive bioadhesive system for prophylaxis and/or treatment of oral mucositis. Gel and film formulations were prepared using chitosans at different molecular weights and in different solvents. Nystatin, which is considered as a prophylactic agent for oral mucositis was incorporated into the formulations. The in vitro release of nystatin from the formulations was decreased with the increasing molecular weight of chitosan. The effect of the formulations was investigated in vivo in hamsters with chemotherapy-induced mucositis. Mucositis scores in groups treated with nystatin incorporated into gel and suspension formulations were significantly lower (p < 0.05) than those treated with the chitosan gel alone. Survival of animals in the treated groups was higher than that in the control group. The retention time and distribution of the gels in the oral cavity were investigated in healthy volunteers. A faster distribution of nystatin in the oral cavity was obtained using the suspension compared to the gels, but the nystatin saliva level decreased rapidly as well. A drug concentration above the minimum inhibitory concentration (MIC) value for Candida albicans (0.14 microg/ml) was maintained for longer periods of time at the application site (90 min) than at the contralateral site (45 min) in the oral cavity.
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Affiliation(s)
- Pelin Aksungur
- Department of Pharmaceutical Technology, Faculty of Pharmacy, Hacettepe University, Ankara 06100, Turkey
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Ameye D, Honraet K, Loose D, Vermeersch H, Nelis H, Remon JP. Effect of a buccal bioadhesive nystatin tablet on the lifetime of a Provox silicone tracheoesophageal voice prosthesis. Acta Otolaryngol 2005; 125:304-6. [PMID: 15966702 DOI: 10.1080/00016480410022778] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
CONCLUSION Daily application of a buccal bioadhesive slow-release nystatin tablet (100,000 IU per tablet) significantly increased the voice prosthesis lifetime in laryngectomized patients compared to conventional local cleaning of the prosthesis with an antimicrobial agent on a brush. OBJECTIVE To investigate the effect of a buccal bioadhesive nystatin tablet on the lifetime of a Provox tracheoesophageal voice prosthesis in post-laryngectomy patients. MATERIAL AND METHODS A buccal bioadhesive tablet, based on a spray-dried Amioca/Carbopol 974P mixture containing 10% (w/w) Carbopol 974P, was loaded with 100,000 IU of nystatin. Patients were included in the study when replacement of their voice prosthesis was required and were divided into three groups. Conventional daily local cleaning of the voice prosthesis by means of an oral nystatin suspension on a brush (Group 1; n = 7) was compared with application of one nystatin buccal bioadhesive tablet per day, after breakfast, on the gingiva above the upper canine (Group 2; n = 7). The control group (n = 5) used no antimicrobial agents. The lifetime of the prosthesis was followed and expressed in days. RESULTS The lifetime of the voice prosthesis was significantly increased in Group 2 compared to Group 1 (p < 0.05; paired t-test), indicating that sustained release of nystatin in the oral cavity, by means of erosion of the tablet over a period of approximately = 8 h, is more effective at preventing microbial colonization of the prosthesis than local cleaning.
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Affiliation(s)
- Dieter Ameye
- Laboratory of Pharmaceutical Technology, Gent University, Belgium
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Offner F, Krcmery V, Boogaerts M, Doyen C, Engelhard D, Ribaud P, Cordonnier C, de Pauw B, Durrant S, Marie JP, Moreau P, Guiot H, Samonis G, Sylvester R, Herbrecht R. Liposomal nystatin in patients with invasive aspergillosis refractory to or intolerant of amphotericin B. Antimicrob Agents Chemother 2005; 48:4808-12. [PMID: 15561860 PMCID: PMC529246 DOI: 10.1128/aac.48.12.4808-4812.2004] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We assessed the activity and safety of liposomal nystatin, a broad-spectrum antifungal agent, for invasive aspergillosis in patients refractory to or intolerant of amphotericin B. Thirty-three patients were enrolled, received at least one dose of the study drug, and were evaluable for safety. Twenty-six patients had confirmed probable or definite aspergillosis and were fully eligible. Most patients had a hematological malignancy (53.8%) or hematopoietic stem cell transplantation (23.0%), were neutropenic (61.5%), and were refractory to previous amphotericin B (92.3%). The median duration of previous amphotericin B treatment was 16.5 days (range, 5 to 64 days). Aspergillosis was definite in 3 cases and probable in 23 cases. Liposomal nystatin was initiated at a dose of 4 mg/kg of body weight/day. Twenty-five patients were evaluable for response: a complete response was achieved for one patient, and a partial response was achieved for six. Thus, the overall response rate is 7 of 25 (28%; 95% confidence interval, 12 to 49%). Seventeen (68.0%) of the 25 evaluable patients died during therapy or within 1 month after the end of therapy. The primary cause of death was invasive aspergillosis for nine patients and underlying malignancy for eight patients. The most frequent side effects included chills, shivering, and fever, leading to discontinuation of therapy for two patients. Grade 1 decline in renal function was seen for 10 (30.3%) patients, and hypokalemia was seen for 13 (39.4%). We conclude that liposomal nystatin can be effective for salvage therapy of invasive aspergillosis. Infusion-related adverse events have been observed frequently.
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Zlatkina AR. [Intestinal candidiasis: modern therapeutic tactics]. Eksp Klin Gastroenterol 2005:15-8, 111. [PMID: 17378380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Bowels candidiasis is an urgent problem not only for gastroenterology but also for other fields of medicine--gynecology, dentistry, phthisiology, surgery, etc. as this disease is directly related with the manifestations of systemic candidiasis in other organs. The diagnostics algorithm includes the detection of a filamentary form (pseudomyceliums) of micromycetes of the Candida genus in the morphological study of a tissue sampling of the bowels mucous coat. The drug of choice for the treatment of bowels candidiasis is Pimafucin (Natamycin) having a local action on the Candida fungi in the intestinal lumen in the absence of any systemic absorption of the drug or any side effects.
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