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Use in Prophylaxis of Oropharyngeal Candidiasis

Myles E. Gombert, MD; Lorraine duBouchet; Taryn M. Aulicino; Khalid M. H. Butt, MD

JAMA. 1987;258(18):2553-2555.

Abstract
An open study designed to compare the effectiveness and safety of clotrimazole troches with nystatin oral suspension in the prevention of oropharyngeal candidiasis was conducted. This study was performed as the troche form of clotrimazole was easier to administer and less costly than nystatin oral suspension. Sixty assessable patients were randomized to receive either clotrimazole troches (n = 32) or nystatin oral suspension (n = 28) for a 60-day period after receiving a renal allograft. The two groups were comparable in age, sex, type of transplant, and amount of immunosuppression. Both regimens were 100% effective in preventing the development of thrush in the patients studied. Adverse effects were infrequently seen in either group (one case of mild nausea in the clotrimazole group and three cases in the nystatin group). One patient chose to withdraw from the clotrimazole group, and eight patients withdrew from the nystatin group before completing 60 days of therapy (P =.002). Reasons given for withdrawal were the unpleasant taste of the drugs, or an inability to comply with the protocol. The cost of clotrimazole troches in the prophylactic doses given in this study was approximately one tenth that of nystatin oral suspension. Clotrimazole troches are effective, less expensive, and easier to self-administer than nystatin oral suspension.

(JAMA 1987;258:2553-2555)

Author Affiliations
From the Division of Infectious Diseases, Department of Medicine (Dr Gombert and Mss duBouchet and Aulicino), and the Division of Transplantation, Department of Surgery (Dr Butt), State University of New York, Health Science Center at Brooklyn.

Footnotes
Reprint requests to Box 56, SUNY Health Science Center at Brooklyn, 450 Clardson Ave, Brooklyn, NY 11203 (Dr Gombert).

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