Comparison of Antifungal Efficacy of Zataria Multiflora and Nystatin for Treatment of Denture Stomatitis: A Randomized Clinical Trial

Investigation of the antifungal effects of curcumin against nystatin-resistant Candida albicans

Background

Emergence of nystatin-resistant Candida albicans (C. albicans) strains has raised some concerns in the recent years. Recent scientific evidence proves that turmeric, especially curcumin, has anti-inflammatory and anti-fungal activity. The aim of this study was the investigation of the antifungal effects of curcumin against nystatin-resistant C. albicans.

Materials and Methods

This in vitro, experimental study evaluated standard-strain (ATCC 16201) and 10 nystatin-resistant C. albicans strains. The antifungal activity and minimum inhibitory concentration (MIC) of curcumin were evaluated using the CLSI-M27-A3, and the MIC of curcumin was compared with that of nystatin. The results were analyzed using the one-way ANOVA.

Results

The MIC of curcumin was 15.6, 32.25, 15.6, 7.8, 32.25, 15.6, 15.6, 15.6, 32.25, and 15.6 μg/mL for the 10 resistant strains and 62.5 μg/mL for the standard strain of C. albicans. Curcumin in the above-mentioned concentrations significantly inhibited the proliferation of nystatin-resistant C. albicans strains (P < 0.001).

Conclusion

According to this research, it was shown that curcumin with MIC value of 7.8-32.25 μg/mL has inhibitory effects on nystatin-resistant C. albicans strains.

Nystatin Effectiveness in Oral Candidiasis Treatment: A Systematic Review & Meta-Analysis of Clinical Trials

Oral candidiasis is the most common opportunistic fungal infection caused by commensal Candida species. Since there are various local and systemic predisposing factors for the disease, the treatment also varies from topical to systemic antifungal agents. Nystatin is a common antifungal agent used topically. The aim of this systematic review was to evaluate and compare the efficacy of different antifungal agents and the safety of nystatin in the treatment of oral candidiasis. Three electronic databases were searched for randomized controlled trials comparing nystatin with other anti-fungal therapies or placebo. Clinical and/or mycological cure was the outcome evaluation. A meta-analysis and descriptive study on the efficacy, treatment protocols, and safety of nystatin was also conducted. The meta-analysis included five studies, which compared the efficacy of nystatin suspensions with photodynamic therapy. A significant difference in the colony-forming units per milliliters (CFU/mL) of Candida species was observed at 60 days intervals for both palatal mucosa and denture surfaces, with both groups favoring nystatin with low heterogeneity at a 95% confidence interval. Nystatin and photodynamic therapy were found to be equally effective for the clinical remission of denture stomatitis as well as a significant reduction of CFU/mL of Candida species from dentures and palatal surfaces of the patients.

Evaluation of the effect of Jaftex herbal mouthwash on the growth of Candida albicans and Candida tropicalis

Background

Increased resistance of Candida albicans to standard antifungal agents has caused special attention to medicinal plants. The aim of this study was to evaluate the effect of Jaftex mouthwash on the growth of C. albicans and Candida tropicalis.

Methods and Material

In this in vitro study, standard strains of C. albicans and C. tropicalis were used. Jaftex mouthwash was prepared with the active ingredient (10g/100cc) of aqueous extract of oak fruit hull (Jaft), Zataria multiflora, and Satureja bachtiarica. The mouthwash was diluted in half, 8 different concentrations were obtained. 10 μl volume of each dilution was poured on discs mounted linearly on the culture medium inoculated with the target fungus. After 24 h, due to the slow growth rate of these fungi, the Petri dishes were incubated at 37°C and the mean minimum inhibitory concentration (MIC) was determined for each fungus. The modified E. test method was used to measure the MIC of Jaftex mouthwash for the two fungi. The experiment was repeated three times for each fungus and the mean value was measured.

Results

The mean value of MIC for C. albicans and C. tropicalis was 0.0625 (mg/mL) and 0.0833 (mg/mL), respectively. Candida albicans appeared to be more sensitive to Jaftex, but no statistically significant difference was observed.

Conclusion

Jaftex mouthwash inhibits the growth of C. albicans and C. tropicalis. The use of this mouthwash is recommended for treatment of oral candidiasis.

Therapeutic Role of Nystatin Added to Tissue Conditioners for Treating Denture-Induced Stomatitis: A Systematic Review

Denture-induced stomatitis (DIS) represents a pathological condition caused by ill-fitting dentures trauma, manifested as inflammation of the palatal tissue beneath the denture. The fungal infections are the principal contributory factors to DIS. Although the aetiology of DIS is multifactorial, the Candida albicans fungal infection remains the main cause. The objective of the present systematic review was to evaluate the latest literature on the addition of nystatin into the tissue conditioners (TCs) in the management of DIS. To search the published literature about “the addition of nystatin in TCs for treating DIS”, electronic databases (PubMed (National library of medicine) and Cochrane Library (Wiley)) were searched (from 1975 until December 2020) using different keywords. Various studies described the effectiveness and efficacy of incorporating nystatin into several TCs. The present systematic review reported that the addition of nystatin is beneficial, with slight or no consequences on both the mechanical and physical features of TCs. Adding nystatin to various TCs for treating DIS can be suggested.