Atividade antifúngica de nanofibras de policaprolactona/nistatina: estudo in vitro e in vivo / Antifungal activity of polycaprolactone/nystatin nanofibers: in vitro and in vivo study

Este estudo avaliou a eficácia in vitro e in vivo de mantas de nanofibras (NF) de policaprolactona (PCL) incorporadas com nistatina (NIS) no tratamento da estomatite protética (EP) em modelos animais. NF foram sintetizadas com diferentes concentrações de NIS, totalizando quatro soluções: PCL puro, PCL/NIS 0,045 g, PCL/NIS 0,090 g e PCL/NIS 0,225 g. A liberação da NIS foi analisada por espectroscopia Ultravioleta-Visível. A capacidade das mantas de inibirem o biofilme de Candida albicans, principal fator etiológico da EP, dividindo-se cinco grupos (N=5) compostos por um grupo com controle de células de C. albicans e com PCL puro, além das três concentrações de NIS. A seguir, foi analisada a viabilidade celular em queratinócitos humanos (HaCat) por meio do teste colorimétrico de resazurina. Cinco grupos foram divididos (N=10): controle celular, PCL puro e as três concentrações de NIS. Em modelos animais de ratos Wistar albinos (N=18), dispositivos palatinos (DP) de resina acrílica foram confeccionados simulando próteses totais e utilizados para a indução da EP. Para isso, DP contaminados com C. albicans foram cimentados na região molar da cavidade bucal dos animais e permaneceram em boca por 48 h. Após esse período, os DP foram removidos e os animais foram divididos em três grupos: (C) controle; (B1) com tratamento por mantas de PCL/NIS 0,045 g e (B2) PCL/NIS 0,225 g, com N=6. Então novos DP, livres de contaminação, foram cimentados na cavidade oral dos animais e permaneceu por mais 48 h. Após esse período, os animais foram eutanasiados, a contagem de UFC/ mL foi realizada e os palatos foram coletados para a análise histológica. A curva padrão de NIS obtida apresentou R2 de 0,99. As três concentrações de NF apresentaram liberação de NIS, com pico no tempo de 6 h e valores de 66,26 µg/ mL para PCL/NIS 0,045 g, de 333,87 µg/ mL para PCL/NIS 0,090 g e 436,51 µg/ mL para PCL/NIS 0,225 g, constantes até o fim do experimento. Os grupos com NIS reduziram em 2,5 log10 de crescimento do biofilme fúngico em relação aos grupos sem tratamento, Controle e PCL, sem diferença estatística significativa. Não foi observada citotoxicidade nas células HaCat, com viabilidade celular de 93,7% para PCL/NIS 0,045 g, 72,6% para PCL/NIS 0,090 g e 72,4% para PCL/NIS 0,225 g. A indução da EP nos três grupos foi possível e, porém, sem redução significativa na contagem de UFC/ mL de C. albicans nos grupos B1 e B2. Na análise histológica do grupo C pôde-se observar infiltração de hifas de Candida na camada queratinizada, presença de células inflamatórias formando micro abscessos e um discreto infiltrado inflamatório no tecido conjuntivo subjacente ao epitélio infectado. Nos grupos B1 e B2 não foram encontradas alterações epiteliais, concluindo-se que as NF demonstraram atividade antifúngica in vitro e foram efetivas na prevenção da penetração de hifas no tecido palatino de animais com DP (AU)

This study evaluated the in vitro and in vivo efficacy of nanofiber (NF) mats of polycaprolactone (PCL) incorporated with nystatin (NIS) in the treatment of denture stomatitis (DS) in animal models. NFs were synthesized with different concentrations of NIS, totaling four solutions: pure PCL, PCL/NIS 0.045 g, PCL/NIS 0.090 g, and PCL/NIS 0.225 g. The release of NIS was analyzed by Ultraviolet-Visible spectroscopy. The ability of the mats to inhibit Candida albicans biofilm, the main etiological factor of DS, was assessed by dividing five groups (N=5) composed of a group with C. albicans cell control and with pure PCL, in addition to the three concentrations of NIS. Next, cell viability in human keratinocytes (HaCat) was analyzed using the resazurin colorimetric test. Five groups were divided (N=10): cell control, pure PCL, and the three concentrations of NIS. In albino Wistar rat animal models (N=18), palatal devices (PD) made of acrylic resin were fabricated to simulate total prostheses and used to induce DS. For this, PD contaminated with C. albicans were cemented in the molar region of the animals' oral cavity and remained in the mouth for 48 hours. After this period, the PDs were removed, and the animals were divided into three groups: (C) control; (B1) treated with PCL/NIS 0.045 g mats, and (B2) PCL/NIS 0.225 g, with N=6. Then new, uncontaminated PDs were cemented in the animals' oral cavity and remained for another 48 hours. After this period, the animals were euthanized, UFC/ mL counts were performed, and the palates were collected for histological analysis. The standard NIS curve obtained showed an R2 of 0.99. The three concentrations of NF showed NIS release, with a peak at 6 h and values of 66.26 µg/ mL for PCL/NIS 0.045 g, 333.87 µg/ mL for PCL/NIS 0.090 g, and 436.51 µg/ mL for PCL/NIS 0.225 g, remaining constant until the end of the experiment. The groups with NIS reduced fungal biofilm growth by 2.5 log10 compared to the untreated groups, Control and PCL, with no significant statistical difference. No cytotoxicity was observed in HaCat cells, with cell viability of 93.7% for PCL/NIS 0.045 g, 72.6% for PCL/NIS 0.090 g, and 72.4% for PCL/NIS 0.225 g. Induction of DS in the three groups was possible; however, there was no significant reduction in UFC/ mL counts of C. albicans in groups B1 and B2. Histological analysis of group C revealed infiltration of Candida hyphae in the keratinized layer, presence of inflammatory cells forming micro abscesses, and a discreet inflammatory infiltrate in the connective tissue underlying the infected epithelium. No epithelial alterations were found in groups B1 and B2, concluding that NFs demonstrated in vitro antifungal activity and were effective in preventing hyphal penetration into palatal tissue in animals with PD.(AU)

Analysis of resistance and sensitivity of 1 200 strains of vulvovaginal candidiasis in China to five common antifungal drugs / 中华妇产科杂志

Objective:To test the antibiotic susceptibility of vulvovaginal candidiasis pathogenic strains to 5 antifungal drugs commonly used in clinic.Methods:A total of 1 200 vulvovaginal candida patients from 23 gynecological and family planning outpatient departments in China were enrolled. Their vaginal secretions were collected for candida strain isolation and species identification. According to Clinical and Laboratory Standards Institute (CLSI) M27-S3, the sensitivity of 1 200 strains to clotrimazole, fluconazole, miconazole, itraconazole and nystatin was tested.Results:(1) The sensitivity and resistance of 1 200 vulvovaginal candidiasis pathogens to 5 antifungal drugs were statistically different ( χ2=3 513.201, P<0.01). (2) All strains had higher sensitivity to nystatin [99.92% (1 199/1 200)], followed by miconazole [92.25% (1 107/1 200)] and clotrimazole [87.17% (1 046/1 200)]. All strains had higher resistance to fluconazole [69.17% (830/1 200)], while itraconazole was 50.83% (610/1 200). (3) There was no significant difference between candida albicans and non-candida albicans in drug sensitivity to nystatin ( P=0.315) and miconazole ( P=0.425). (4) Candida albicans and non-candida albicans showed different sensitivity to clotrimazole, fluconazole and itraconazole, respectively. Compared with non-candida albicans, candida albicans showed higher sensitivity to clotrimazole [susceptibility rate: 73.01% (165/226) vs 90.45% (881/974); P<0.001] and higher resistance to fluconazole [resistance rate: 50.88% (115/226) vs 73.41% (715/974); P<0.001]. Although the drug sensitivity of itraconazole was not high, the susceptibility rate of candida albicans to itraconazole was slightly higher than that of non-candida albicans [37.68% (367/974) vs 23.89% (54/226)], and the drug resistance rate was lower [49.28% (480/974) vs 57.52% (130/226)]. Conclusions:The sensitivity of 1 200 strains of candida to 5 antifungal drugs is significantly different, the sensitivity rate of nystatin, miconazole and clotrimazole are higher, but the resistance rate of fluconazole and itraconazole are higher. The sensitivity of candida albicans and non-candida albicans to the same drug is also significantly different. It is suggested that in clinical diagnosis and treatment, we should pay attention to the identification of candida and drug sensitivity test, so as to select antifungal drugs rationally.

Effects of nystatin oral care combined with health education in preventing oral fungal infection in patients with severe hepatitis / 中国实用护理杂志

Objective:To explore the risk factors of oral fungal infection in patients with severe hepatitis, and the prevention role of nystatin oral care combined with precision health education on oral fungal infection.Methods:A total of 150 patients with severe hepatitis who were hospitalized for diagnosis and treatment in the First Affiliated Hospital of Zhengzhou University from February 2018 to February 2020 were selected as the research objects. According to the random number table method, they were divided into the observation group (given nystatin oral care combined with precision health education intervention) and the control group (given routine oral care combined with precision health education intervention), 75 cases in each group. The incidence of oral fungal infections in the two groups after the intervention were compared.Results:The fungal infection rate in the observation group at 1 week, 2 weeks and 4 weeks after intervention were 2.67% (2/75), 4.00% (3/75), 8.00% (6/75), which were significantly lower than 12.00% (9/75), 18.67% (14/75), 25.33% (19/75) in the control group ( χ2=4.81, 8.03, 8.11, all P<0.05). Four weeks after the intervention, among the 6 patients with fungal infection in the observation group, there were 5 cases of oral leukoplakia and foreign body sensation in the pharynx, and 1 patient with oral leukoplakia; among the 19 patients with fungal infection in the control group, all had oral mucosal leukoplakia. There were 17 cases of leukoplakia and pharyngeal foreign body sensation, and 2 cases of oral leukoplakia. Conclusions:Nystatin oral care combined with precision health education is of great significance in patients with severe hepatitis, and can effectively reduce the incidence of oral fungal infections.

Acanthus ilicifolius L. Treatment for Oral Candidiasis with Immunosuppressive Conditions Subjected to p38 MAPK Enhancement

ABSTRACT@#Methanolic extract from the leaves of Acanthus ilicifolius L. (A. ilicifolius L.) is a potent inhibitor of Candida albicans (C. albicans) growth and anti-inflammatory. C. albicans causes oral candidiasis in immunosuppressive condition. Mitogen-activated protein kinase (MAPK) signalling via p38 appears to discriminate between yeast and hyphal cells of C. albicans. Activation of p38 MAPK by hyphae results in the upregulation of proinflammatory cytokines. The p38 MAPK activation is known to impair corticosteroid action. The research was conducted to investigate the effect of methanolic extract A. ilicifolius L. treatment of oral candidiasis with the immunosuppressive condition through enhancement of p38 MAPK expression in the epithelial cells. Immunosuppressed conditions were obtained when 16 healthy male Rattus norvergicus (Wistar) was given oral administration of dexamethasone and tetracycline for 14 days and induced with C. albicans (ATCC-10231) 1 McFarland. The subjects were divided into four groups (n = 4/group): immunosuppression (IS), immunosuppression with oral candidiasis without treatment (ISC), immunosuppression with oral candidiasis and nystatin treatment (ISC+N), and immunosuppression with oral candidiasis and A. ilicifolius L. treatment (ISC+AI), and were treated for 14 days. Later, the rats were euthanised, and their tongue were biopsied. The p38 MAPK expression was subjected to immunohistochemical examination, observed under a microscope (400× magnification) and statistically analysed (one-way ANOVA, LSD-test, p < 0.05). The p38 MAPK expression of ISC+AI (36.05 ± 1.54) was higher than IS (26 ± 2.32), ISC (26.4 ± 3.71), IS+N (34.2 ± 0.99). Significant differences existed between ISC+AI and ISC+N to IS and ISC (p < 0.05). No significant differences were present between IS and ISC; ISC+AI and ISC+N (p > 0.05). Therefore, this treatment could enhance p38 MAPK expression in oral candidiasis with the immunosuppressed condition.

Efficacy of copper sulphate on candida albicans on heat-polymerized acrylic resin / Eficacia del sulfato de cobre sobre candida albicans en resinas acrílicas de termocurado

The ageing of population is increasing, and a great percentage of these patients wear removable prostheses, and can suffer denture stomatitis, a condition that has been associated with candidiasis. Aims: To evaluate in vitro the effectiveness of Copper Sulfate against Candida albicans in samples of heat-polymerized acrylic resin, compared to nystatin, sodium hypochlorite and chlorhexidine. Materials and Methods: Initially, the minimum inhibitory concentration (MIC) of copper sulfate for Candida albicans was determined by microdilution. Then, 54 resin samples were divided into 6 treatment groups corresponding to Nystatin 100.000 UI, Sodium Hypochlorite 0.5%, chlorhexidine 0.12%, Copper Sulfate 4.7µg/ml, Copper Sulfate 9.4µg/ml and physiological saline solution, in which samples were submerged for 6 hours. Resin samples were then washed and cultured on solid media at 37°C for 72 hours. The number of colony-forming units was determined using a Quebec colony counter. The statistical analysis was performed using the Kruskal-Wallis test and the Mann-Whitney U test. Results: Copper sulfate at a concentration of 9.4µg/ml presented a similar effectiveness as the other control products regarding the reduction in the number of colonies of Candida albicans post-treatment. Conclusion: The effectiveness of copper sulfate against Candida albicans on acrylic resin was similar to that of nystatin, sodium hypochlorite and chlorhexidine.

En las últimas décadas se ha observado un aumento de la población de adultos mayores, de los cuales un gran porcentaje es portador de prótesis removible, y dos tercios pueden sufrir estomatitis subprotésica, enfermedad que es asociada a infecciones como candidiasis. Objetivo: Evaluar la efectividad antimicótica in vitro del sulfato de cobre en placas de resinas acrílicas de termocurado inoculadas con Candida albicans, frente a Nistatina, Hipoclorito de Sodio y Clorhexidina. Material y Métodos: Inicialmente, y mediante microdilución del sulfato de cobre, se determinó la concentración mínima inhibitoria (CMI) para Candida albicans. En la fase experimental, 54 muestras de resina se dividieron en 6 grupos correspondientes a Nistatina 100.000 UI, Hipoclorito 0.5%, Clorhexidina 0.12%, Sulfato de Cu 4.7µg/ml, Sufato de Cu 9.4 µg/ml y suero fisiológico. Las muestras fueron sumergidas en estos agentes por 6 horas, para posteriormente ser lavadas y cultivada en medios solidos a 37°C por 72 horas. Luego se realizó el conteo de unidades formadoras de colonias mediante contador tipo Quebec. El análisis estadístico se realizó mediante la prueba de Kruskal-Wallis y la prueba U de Mann-Whitney. Resultado: El sulfato de cobre a una concentración de 9.4µg/ ml presentó una efectividad similar a los otros productos, en la reducción de colonias de Candida albicans. Conclusión: La efectividad del sulfato de cobre contra Candida albicans fue semejante a la de Nistatina, Hipoclorito y Clorhexidina.

Atividade antifúngica do a-terpinen sobre Candida albicans / Antifungal activity of a-terpinen on Candida albicans

Objetivo: avaliar a atividade antifúngica do a- terpinen sobre culturas planctonicas e biofilme de Candida albicans. Material e Métodos: Primeiramente, foi determinada a Concentração Inibitória Mínima (CIM) e a Concentração Fungicida Mínima (CFM) do a-terpinen sobre microrganismos planctônicos. A Nistatina foi utilizada como controle positivo. Biofilme de Candida albicans foi desenvolvido e, após o tratamento com diferentes concentrações de α-terpinen, foi quantificado em UFC/mL, além da atividade metabólica das células ser avaliada por XTT. Resultados: a menor concentração capaz de inibir o crescimento (CIM) foi 0,2 % para o a-terpinen e 4 µg/mL para a Nistatina. Na CIM, os resultados mostraram que a partir da concentração 0,05 % de α-terpinen e 2 µg/mL de Nistatina houve diminuição de C.albicans quando comparado ao controle. A CFM foi para a-terpinen 0,2 % e Nistatina 8 µg/mL. Na quantificação as concentrações eficazes foram de α-terpinen (0,1%) e Nistatina (128µg/mL), e no teste do XTT, observou-se que α -terpinen (0,1%) e Nistatina (256µg/mL) diminuem a viabilidade quando comparado com o controle. Conclusão: Assim, pode-se afirmar que α -terpineol pode ser uma alternativa para tratamento de infecções fúngicas.

Objective: to evaluate the antifungal activity of a-terpinen on planktonic cultures and biofilm of Candida albicans. Material and Methods: first, Minimum Inhibitory Concentration (MIC) and Minimum Fungicidal Concentration (CFM) of a-terpinen were determined. Nystatin was used as a positive control. Biofilm of Candida albicans was developed and, after treatment with different concentrations of a-terpinen, was quantified in CFU/mL, in addition to metabolic activity of the cells being evaluated by XTT. Results: the lowest concentration able to inhibit the growth (MIC) was 0.2% for a-terpinen and 4 µg / mL for Nystatin. Results showed that from the concentration 0.05% of α -terpinen and 2 µg / mL of Nystatin, there was a decrease of Candida albicans when compared to the control, in planktonic culture. CFM was 0.2% for α -terpinen and 8 µg / mL for Nystatin. Regarding the quantification, effective concentrations were α-terpinen (0.1%) and Nystatin (128 µg/mL), and in the XTT test, α-terpinen (0.1%) and Nystatin (256 µg/mL) decreased metabolic activity when compared to control. Conclusion: Thus, it can be stated that a-terpineol may be an alternative for the treatment of fungal infections.

Avaliação in vitro do potencial erosivo e cariogênico de antifúngicos tópicos / In vitro evaluation of erosive and cariogenic potential of topical antifungal agents

Introdução: a candidíase é uma infecção fúngica oportunista, causada pela proliferação e disseminação de espécies de Candida, que pode acometer a cavidade oral. Dentre os antifúngicos mais utilizados e de uso tópico, a nistatina é considerada o medicamento de primeira escolha. Objetivo: avaliar as propriedades físico-químicas de diferentes marcas de nistatina disponíveis no mercado, incluindo o pH, a acidez total titulável (ATT) e a determinação de sólidos solúveis totais (SST). Metodologia: trata-se de um estudo experimental in vitro, constituído por uma amostra de oito diferentes marcas de nistatina em suspensão oral de uso tópico. Foi analisado o potencial erosivo e cariogênico dessas soluções mediante a determinação de pH, ATT e SST (°Brix). Resultados: no tocante ao pH, verificou-se que a média obtida foi de 6,05 (± 0,66). Dois dos medicamentos analisados (marcas A e H) apresentaram pH abaixo do crítico para a dissolução do esmalte dental. Quanto à ATT das soluções, os valores variaram de 1,9 a 14,53 mL para atingir o pH neutro, indicando que as marcas B, C e E podem levar mais tempo para ser neutralizadas em razão da quantidade de solução necessária. A análise do °Brix revelou que a marca H apresentou o maior teor de açúcares em sua composição (44,9%). Conclusão: a formulação de nistatina da marca H apresentou pH endógeno mais crítico e percentual de sólidos solúveis totais elevado, sendo, portanto, a medicação com maior fator de risco para o desenvolvimento de cárie e erosão dentária, devendo ser consideradas as doses e frequências de uso, bem como os hábitos de higiene oral do paciente

Introduction: candidiasis is an opportunistic fungal infection caused by the proliferation and spread of Candida species that can affect the oral cavity. Among the most commonly used topical antifungal agents, nystatin is considered the first choice drug. Methodology: to evaluate the physical and chemical properties of different brands of nystatin available in the market, including pH, titratable acidity and determination of total soluble solids. Results: Regarding pH, it was verified that the mean obtained was 6.05 (± 0.66). Two of the analyzed drugs (A and H) presented pH below that considered critical for the dissolution of dental enamel. As for the titratable total acidity of the solutions, values ranged from 1.9 to 14.53 mL to reach neutral pH, indicating that the B, C and E marks may take longer to neutralize because of the amount of solution required. The analysis of ° Brix revealed that the H mark had the highest sugar content in its composition (44.9%). Conclusion: Nystatin brand H presented the worst indices in terms of endogenous pH and total sugar percentage, being therefore the medication with the highest risk factor for the development of caries and dental erosion.

Interactions between Terpinen-4-ol and Nystatin on biofilm of Candida albicans and Candida tropicalis

Abstract The aim of this study was to evaluate the antifungal activity of Terpinen-4-ol associated with nystatin, on single and mixed species biofilms formed by Candida albicans and Candida tropicalis, as well as the effect of terpinen-4-ol on adhesion in oral cells and the enzymatic activity. The minimum inhibitory concentrations and minimum fungicide concentrations of terpinen-4-ol and nystatin on Candida albicans and Candida tropicalis were determined using the microdilution broth method, along with their synergistic activity ("checkerboard" method). Single and mixed species biofilms were prepared using the static microtiter plate model and quantified by colony forming units (CFU/mL). The effect of Terpinen-4-ol in adhesion of Candida albicans and Candida tropicalis in coculture with oral keratinocytes (NOK Si) was evaluated, as well as the enzymatic activity by measuring the size of the precipitation zone, after the growth agar to phospholipase, protease and hemolysin. Terpinen-4-ol (4.53 mg mL-1) and nystatin (0.008 mg mL-1) were able to inhibit biofilms growth, and a synergistic antifungal effect was showed with the drug association, reducing the inhibitory concentration of nystatin up to 8 times in single biofilm of Candida albicans, and 2 times in mixed species biofilm. A small decrease in the adhesion of Candida tropicalis in NOK Si cells was showed after treatment with terpinen-4-ol, and nystatin had a greater effect for both species. For enzymatic activity, the drugs showed no action. The effect potentiated by the combination of terpinen-4-ol and nystatin and the reduction of adhesion provide evidence of its potential as an anti-fungal agent.

Resumo O objetivo desse estudo foi avaliar a atividade antifúngica do Terpinen4-ol associado à nistatina em biofilmes simples e misto, formados por Candida albicans e Candida tropicalis, bem como o efeito do terpinen-4-ol na adesão em células orais e atividade enzimática. As concentrações inibitórias mínimas e as concentrações fungicidas mínimas do terpinen-4-ol e da nistatina em Candida albicans e Candida tropicalis foram determinadas pelo método de microdiluição em caldo, juntamente com a atividade sinérgica (método do tabuleiro de "xadrez"). Biofilmes simples e misto foram preparados usando o modelo de placa de microtitulação estática e quantificados por unidades formadoras de colônias (CFU/mL). O efeito do Terpinen-4-ol na adesão de Candida albicans e Candida tropicalis em co-cultura com queratinócitos orais (NOK Si) foi avaliado, bem como a atividade enzimática, medindo o tamanho da zona de precipitação, após o crescimento em ágar fosfolipase, protease e hemolisina. O terpinen-4-ol (4.53 mg mL-1) e a nistatina (0,008 mg mL-1) conseguiram inibir o crescimento de biofilmes e um efeito antifúngico sinérgico foi demonstrado com a associação de fármaco, reduzindo a concentração inibidora de nistatina até 8 vezes em biofilme simpes de Candida albicans e 2 vezes em biofilme misto. Uma pequena diminuição na adesão de Candida tropicalis em células NOK Si foi mostrada após o tratamento com terpinen-4-ol e a nistatina teve um efeito maior para ambas as espécies. Para a atividade enzimática, as drogas não apresentaram ação. O efeito potencializado pela combinação de terpinen-4-ol e nistatina e a redução de adesão evidenciam seu potencial como agente anti-fúngico.

Efficacy of nystatin vaginal effervescent tablets and nifuratel tablet combined with recombinant human interferon alpha 2b suppository in the treatment of candida vaginitis / 中国基层医药

Objective To explore the efficacy of nystatin vaginal effervescent tablets , nifuratel tablet combined with recombinant human interferon alpha 2b suppository in the treatment of candida vaginitis .Methods 124 patients with candida vaginitis were selected as the research subjects .The patients were randomly divided into two groups according to different treatment .The control group was treated with nystatin vaginal effervescent tablets +nifuratel tablet,the study group was given recombinant human interferon alpha 2b suppository on the basis of the control group.The symptoms,clinical curative effect,quality of life score,adverse reaction rate were observed and compared in the two groups .Results There were no statistically significant differences between the two groups in symptom and physical signs before treatment (all P>0.05).After treatment,the vulvar itching,burning pain,abnormal leucorrhea,redness symptoms and signs of the study group were (0.95 ±0.44)points,(1.02 ±0.51)points,(1.13 ± 0.62) points,(1.09 ±0.56) points,which were significantly lower than those of the control group [(1.42 ± 0.98)points,(1.28 ±1.02)points,(1.38 ±1.17)points,(1.37 ±1.12)points,t=2.529,2.512,2.505,2.618,all P<0.05].The total effective rate of the study group was 95.2％,which was significantly higher than 74.2％ of the control group (Z=-2.839,P<0.05).After treatment,the quality of life scores of physiological function ,bodily pain,mental health,emotional function and social function in the study group were (80.16 ±9.23)points,(84.22 ± 9.95)points,(87.49 ±10.46) points,(89.27 ±12.35) points,(88.21 ±11.74) points,which were significantly higher than those in the control group[(67.58 ±5.34)points,(71.49 ±7.28)points,(73.52 ±7.61)points,(76.83 ±8.32)points,(75.51 ±8.16) points,t=9.728,8.577,9.036,7.039,7.537,all P<0.05].The incidence rate of adverse reactions of the study group was significantly lower than that of the control group (χ2 =10.978,P<0.05). Conclusion Nystatin vaginal effervescent tablets ,nifuratel tablet combined with recombinant human interferon alpha 2b suppository in the treatment of candida vaginitis can significantly improve clinical symptoms ,improve the therapeutic effect,and improve the quality of life of patients with significant clinical value ,it is worthy of reference .

Antifungal Activity of Eugenol and its Association with Nystatin on Candida albicans

Objective: To evaluate the anti-Candida effect of eugenol and its antimicrobial interaction with nystatin. Material and Methods: The antimicrobial potential was assessed by microdilution technique (M27A3 reference method), by determining the minimum inhibitory concentration (MIC) and the minimum fungicidal concentration (MFC) against C. albicans (ATCC 90028). The possible action of eugenol on the fungal cell wall was evaluated with the assistance of the osmotic protector sorbitol (0.8 M). The antimicrobial interaction with nystatin was assessed through the checkerboard method. All tests were performed in triplicate. Results: All groups showed reductions in PI and GBI values and improvements in oral health knowledge, but IG1 and IG2 showed statistically significant differences in these variables compared to CG. Conclusion: The eugenol has antifungal activity against C. albicans and its mechanism of action is probably not related to damage to the fungal cell wall. Association between eugenol and nystatin was not found to be an advantageous possibility for growth inhibition of C. albican.

In Vitro Assessment of Antileishmanial Activity of Natamycin and Nystatin

ABSTRACT The present study was aimed to evaluate the in vitro antileishmanial activity of four different concentrations of natamycin and nystatin by using MTT 3-(4.5-dimethylthiazol-2-yl)-2.5-diphenyl tetrazolium bromide reduction assay. In vitro antileishmanial activity revealed that the IC50 of natamycin (80.49 μg/ml) and nystatin (105.7 μg/ml) was less than that of sodium stibogluconate (127.9 μg/ml), and more than amphotericin B (18.91 μg/ml).

Clinical effect of Fuke Xiaoyan prescription combined with nifuratel and nysfungin in senile mycotic vaginitis / 中国生化药物杂志

Objective To analyze the effect of Fuke Xiaoyan prescription combined with nifuratel and nysfungin in senile mycotic vaginitis. Methods 100 patients with senile mycotic vaginitis were randomly divided into the observation group and the control group ,50 cases in each group.The control group were treated with nifuratil nystatin alone.The observation group were treated with Fuke Xiaoyan prescription.The inflammatory factors of tumor necrosis factor (TNF-α), C-reactive protein (CRP), interleukin-6 (IL-6) and interleukin-8 (IL-8) and oxidative stress products of SOD, nitric oxide (NO), malondialdehyde (MDA) and endothelin-1 (ET-1) were determined before and after treatment in the two groups.Results The effective rates of the treatment group and the control group were 96.0% and 80.0% respectively.The clinical efficacy of the observation group was higher than that of the control group ( P<0.05 ) .The difference of the inflammatory factors between the two groups was statistically significant ( P<0.05 ) .The levels of SOD and NO in the two groups were significantly higher than those in the control group (P<0.05), but the levels of the inflammatory factors in the observation group were significantly lower than those in the control group ( P<0.05 ) .The levels of MDA and ET-1 in observation group were significantly lower than those in control group (P<0.05).Conclusion Fuke Xiaoyan prescription combined with nifuratil and nystatin has a good effect in the treatment of senile mycotic vaginitis.It can effectively relieve the inflammatory reaction and reduce the level of oxidative stress products , thus improving the patients'life quality.

Efficacy of Saccharomyces boulardii in treatment of candida esophagitis / 中华全科医师杂志

The efficacy and safety of Saccharomyces boulardii in treatment of candida esophagitis was investigated by a single center, prospective, open label and non-inferiority trial.Eighty nine patients with candida esophagitis attending in Shanxi Provincial People′s Hospital during April 2015 to March 2016 were randomly divided into Saccharomyces boulardii group (45 cases) and nystatin group (44 cases), and oral Saccharomyces boulardii powder and Nystatin tablets were given to two groups respectively.The curative effect was evaluated by gastroscopy after the treatment.The results showed that the cure rate of Saccharomyces boulardii group and nystatin group was 68.9%(31/45)and 63.6%(28/44), and the Saccharomyces boulardii was noi inferior to nystatin (x2=3.027, P0.05].The incidence of adverse reactions in boulardii group was significantly lower than that in nystatin group [2.2%(1/45) vs.22.7%(10/44), x2=8.636, P<0.05].The study suggests that the cure rate of Saccharomyces boulardii is not inferior to nystatin in treatment of candida esophagitis, while the incidence of adverse reactions of Saccharomyces boulardii is lower.

Activity of the aqueous extract of Schinus terebinthifolius Raddi on strains of the Candida genus / Atividade do extrato aquoso de Schinus terebinthifolius Raddi sobre cepas do gênero Candida

ABSTRACT Objectives: To evaluate the antifungal susceptibility profile of the aqueous extract of the bark of Schinus terebinthifolius Raddi against the strains of the genus Candida. Methods: By using the disk diffusion method, 50 samples of the genus Candida (Candida albicans; Candida krusei; Candida glabrata; and Candida tropicalis), isolated from patients receiving treatment at Hospital Santa Casa de Misericórdia de São Paulo, and 1 American Type Culture Collection (ATCC) sample of each species were tested against: the isolated aqueous extract of the bark of Schinus terebinthifolius Raddi, isolated nystatin, and the association of nystatin and the aqueous extract of Schinus terebinthifolius Raddi. Results: There were no significant differences regarding the different strains of Candida tested. In the presence of the aqueous extract of Schinus terebinthifolius Raddi, no inhibition halo was visible. Isolated nystatin formed an inhibition halo measuring respectively 18.50 mm and 19.50 mm for the Candida albicans species and the others referred to as non-Candida albicans (Candida krusei; Candida glabrata; and Candida tropicalis). The association of nystatin and the aqueous extract of Schinus terebinthifolius Raddi resulted in inhibition halos measuring 14.25 mm and 16.50 mm respectively. The comparisons of these results are statistically significant (p < 0,001). Conclusion: The aqueous extract of Schinus terebinthifolius Raddi showed no antifun-gal activity in vitro against the strains tested, whereas the association of nystatin and the aqueous extract of Schinus terebinthifolius Raddi caused a decrease in the inhibition halo when compared with isolated nystatin.

RESUMO Objetivos: Avaliar o perfil de susceptibilidade antifúngica do extrato aquoso das cascas de Schinus terebinthifolius Raddi frente às cepas do gênero Candida. Métodos: Por meio do método de difusão em disco, 50 amostras do gênero Candida (Candida albicans, Candida krusei, Candida glabrata e Candida tropicalis) provenientes de pacientes do Hospital da Santa Casa de Misericórdia de São Paulo, e 1 amostra American Type Culture Collection (ATCC) de cada espécie foram testadas frente ao extrato aquoso das cascas de Schinus terebinthifolius Raddi isolado, nistatina isolada, e a associação da nistatina ao extrato aquoso de Schinus terebinthifolius Raddi. Resultados: Não houve diferenças significantes em relação às diferentes espécies de cepas de Candida testadas. O extrato aquoso de Schinus terebinthifolius Raddi não formou halo de inibição. A nistatina isolada formou halo de inibição de 18,50 mm e 19,50 mm respectivamente para as espécies Candida albicans e as demais nomeadas como não Candida albicans (Candida krusei, Candida glabrata e Candida tropicalis). A associação da nistatina ao extrato aquoso de Schinus terebinthifolius Raddi resultou no halo de inibição de 14,25 mm e 16,50 mm respectivamente, sendo que as comparações destes resultados são estatisticamente significantes (p < 0,001). Conclusão: O extrato aquoso de Schinus terebinthifolius Raddi não demonstrou propriedade antifúngica in vitro frente às cepas testadas, e a associação da nistatina ao extrato aquoso de Schinus terebinthifolius Raddi causou a diminuição do halo de inibição quando comparado à nistatina isolada.

Obtenção de gel mucoadesivo de nistatina para o tratamento da candidíase oral. Desenvolvimento e caracterização de dispersões sólidas de nistatina / Mucoadhesive gel obtaining nystatin for the treatment of oral candidiasis. Development and characterization of solid dispersions of nystatin

A nistatina (NYS) é o fármaco de primeira escolha no tratamento da candidíase oral, que frequentemente acomete mais os indivíduos imunocomprometidos e pacientes com outras desordens (diabetes não tratada, neoplasias, imunodeficiências). No mercado brasileiro, a NYS é encontrada na forma de suspensão oral aquosa, onde o procedimento para sua administração consiste em bochechar o medicamento. Apesar de haver a indicação de que se mantenha o contato direto entre fármaco e a mucosa oral, na qual se encontra a Candida spp., o que aumentaria expressivamente o sucesso terapêutico, a suspensão não apresenta tal propriedade. Assim, a NYS que é fármaco com ação efetiva contra a candidíase oral, é considerada pertencente à Classe IV do Sistema de Classificação Biofarmacêutica, ou seja, apresenta baixa solubilidade e baixa permeabilidade. A baixa solubilidade pode comprometer sua disponibilidade na cavidade oral, e consequentemente, sua ação farmacológica. Diante desse quadro, o objetivo do presente trabalho foi o desenvolvimento de dispersões sólidas de NYS para o tratamento da candidíase oral, e sua posterior incorporação em gel mucoadesivo oral, favorecendo a formulação no local de ação. As dispersões sólidas são sistemas farmacêuticos, onde um fármaco pouco solúvel em água encontra-se dispersado em um carreador, no estado sólido. Os carreadores normalmente são hidrofílicos, o que permite que esses sistemas sejam empregados para aumentar a solubilidade aquosa do fármaco. Assim, foram desenvolvidas as dispersões sólidas de NYS, pelo método de eliminação do solvente, empregando como carreadores, lactose, HPMC, poloxamer 407 e poloxamer 188. Essas foram submetidas à caracterização por análise térmica, usando os ensaios de calorimetria exploratória diferencial (DSC) e termogravimetria/termogravimetria derivada (TG/DTG). Dentre essas dispersões sólidas, aquelas que se mostraram com comportamento térmico sugerindo a formação de um novo "sistema", foram analisadas por meio de ensaio de solubilidade. Dessa forma, a formulação NYS DS G2 (49) se destacou, pois apresentou maior solubilidade em água (4,484 mg/mL); em pH 5,5 (4,249 mg/mL) e em pH 7,0 (4,293 mg/mL), ou seja, houve um aumento de 1,426 vezes em água; 4,227 vezes em pH 5,5; e 2,743 vezes em pH 7,0. Essa formulação foi, por fim avaliada por difração de raio-X e espectroscopia de infravermelho com transformada de Fourier, técnicas que corroboraram com a análise térmica quanto à indicação de formação da dispersão sólida. Por sua vez, essa dispersão sólida foi incorporada em 4 bases de géis mucoadesivos de carbopol ® 934 PNF, alterando apenas a concentração do polímero (0,5; 1,0; 1,5; 2,0 %p/p). Foi observado que a liberação de NYS DS G2 (49) foi superior, quando comparada à liberação de NYS MP a partir do gel, e através do ensaio de mucoadesão, percebeu-se que os géis desenvolvidos apresentaram propriedades mucoadesivas compatíveis com relatos na literatura, independentemente da quantidade de carbopol ® empregada. As características reológicas foram distintas, e foi observado que as formulações Gel A e Gel B, que possuem menor quantidade de polímero, tiverem um indicativo de comportamento de fluido newtoniano, diferente dos demais, o que pode não ser desejado para esse tipo de forma farmacêutica tópica e semi-sólida. Ao final desse trabalho, pode-se concluir que foi possível desenvolver um sistema farmacêutico na forma de dispersão sólida com maior solubilidade que a NYS pura, e sua incorporação em uma forma farmacêutica mucoadesiva, e que a liberação da NYS na forma DS foi muito superior que o fármaco na forma "convencional", o que permite que a NYS esteja mais disponível na cavidade oral, e também junto à mucosa bucal, o que levaria a efeito farmacológico mais efetivo do antifúngico

Nystatin (NYS) is the drug of first choice in the treatment of oral candidiasis that most often affect immunocompromised individuals, and patients with other disorders. In the Brazilian market, NYS is found in the form of aqueous oral suspension, a medication used in the form of mouthwash. Although there is an indication to maintain direct contact between the drug and the oral mucosa, where Candida spp. is found, as well as where therapeutic success would significantly be increased, the suspension has no such property. Thus, the NYS is an effective drug against oral candidiasis, and belongs to Class IV of the Biopharmaceutical Classification System, it has low solubility and low permeability. The low solubility can compromise its availability in the oral cavity, and consequently, its pharmacological action. Given this situation, the objective of this work was the development of solid dispersions of NYS for the treatment of oral candidiasis, and its subsequent incorporation into oral mucoadhesive gel, in order to facilitate its action. Solid dispersions are pharmaceutical systems, in which a solid drug poorly soluble in water is dispersed in a carrier. These carriers are usually hydrophilic, and this allows the systems to be employed in order to increase the aqueous solubility of the drug. Thus, the solid NYS dispersions were developed by the solvent evaporation method, employing lactose, HPMC, poloxamer 407 and poloxamer 188 as carrier. These samples were subjected to characterization by thermal analysis, using differential scanning calorimetry (DSC) and thermogravimetry / derivative thermogravimetry (TG / DTG). Among these solid dispersions, those samples which showed a specific thermal behavior suggesting the formation of new "system" were analyzed by solubility test. Thus, the NYS DS G2 formulation (49) stood out, once it showed greater solubility in water (4.484 mg/mL); at pH 5.5 (4.249 mg/mL) and pH 7.0 (4.293 mg/mL), in other words, an increase of 1,426 times in water; 4,227 times at pH 5.5; and 2,743 times at pH 7.0. This formulation was finally evaluated by X-ray diffraction, infrared spectroscopy with Fourier transform, techniques that corroborate the thermal analysis, indicating the formation of the solid dispersion. On the other hand, this solid dispersion was incorporated into 4 Carbopol ® 934 PNF mucoadhesive gels, with a variation of the polymer concentration. It was observed that NYS is improved of delivery from the gels, employing mucoadhesion test, and was also observed that the gels have mucoadhesive properties consistent with reports in the literature. However, the rheological characteristics are different, and it was observed that the Gel A and Gel B formulations, which has a lower amount of polymer behaved as a Newtonian fluid, which may not be desired for this type of topical gel. As conclusion, it was possible to develop a pharmaceutical system in the form of solid dispersion with greater solubility than the pure NYS, and their incorporation in a mucoadhesive dosage form and the release of NYS as DS was far superior wherein the drug in the "conventional" manner, which allows the NYS is longer available in the oral cavity, and also adjacent to the buccal mucosa, leading to more effective pharmacological effect of the antifungal agent

Obtenção de gel mucoadesivo de nistatina para o tratamento da candidíase oral. Desenvolvimento e caracterização de dispersões sólidas de nistatina / Mucoadhesive gel obtaining nystatin for the treatment of oral candidiasis. Development and characterization of solid dispersions of nystatin

A nistatina (NYS) é o fármaco de primeira escolha no tratamento da candidíase oral, que frequentemente acomete mais os indivíduos imunocomprometidos e pacientes com outras desordens (diabetes não tratada, neoplasias, imunodeficiências). No mercado brasileiro, a NYS é encontrada na forma de suspensão oral aquosa, onde o procedimento para sua administração consiste em bochechar o medicamento. Apesar de haver a indicação de que se mantenha o contato direto entre fármaco e a mucosa oral, na qual se encontra a Candida spp., o que aumentaria expressivamente o sucesso terapêutico, a suspensão não apresenta tal propriedade. Assim, a NYS que é fármaco com ação efetiva contra a candidíase oral, é considerada pertencente à Classe IV do Sistema de Classificação Biofarmacêutica, ou seja, apresenta baixa solubilidade e baixa permeabilidade. A baixa solubilidade pode comprometer sua disponibilidade na cavidade oral, e consequentemente, sua ação farmacológica. Diante desse quadro, o objetivo do presente trabalho foi o desenvolvimento de dispersões sólidas de NYS para o tratamento da candidíase oral, e sua posterior incorporação em gel mucoadesivo oral, favorecendo a formulação no local de ação. As dispersões sólidas são sistemas farmacêuticos, onde um fármaco pouco solúvel em água encontra-se dispersado em um carreador, no estado sólido. Os carreadores normalmente são hidrofílicos, o que permite que esses sistemas sejam empregados para aumentar a solubilidade aquosa do fármaco. Assim, foram desenvolvidas as dispersões sólidas de NYS, pelo método de eliminação do solvente, empregando como carreadores, lactose, HPMC, poloxamer 407 e poloxamer 188. Essas foram submetidas à caracterização por análise térmica, usando os ensaios de calorimetria exploratória diferencial (DSC) e termogravimetria/termogravimetria derivada (TG/DTG). Dentre essas dispersões sólidas, aquelas que se mostraram com comportamento térmico sugerindo a formação de um novo "sistema", foram analisadas por meio de ensaio de solubilidade. Dessa forma, a formulação NYS DS G2 (49) se destacou, pois apresentou maior solubilidade em água (4,484 mg/mL); em pH 5,5 (4,249 mg/mL) e em pH 7,0 (4,293 mg/mL), ou seja, houve um aumento de 1,426 vezes em água; 4,227 vezes em pH 5,5; e 2,743 vezes em pH 7,0. Essa formulação foi, por fim avaliada por difração de raio-X e espectroscopia de infravermelho com transformada de Fourier, técnicas que corroboraram com a análise térmica quanto à indicação de formação da dispersão sólida. Por sua vez, essa dispersão sólida foi incorporada em 4 bases de géis mucoadesivos de carbopol ® 934 PNF, alterando apenas a concentração do polímero (0,5; 1,0; 1,5; 2,0 %p/p). Foi observado que a liberação de NYS DS G2 (49) foi superior, quando comparada à liberação de NYS MP a partir do gel, e através do ensaio de mucoadesão, percebeu-se que os géis desenvolvidos apresentaram propriedades mucoadesivas compatíveis com relatos na literatura, independentemente da quantidade de carbopol ® empregada. As características reológicas foram distintas, e foi observado que as formulações Gel A e Gel B, que possuem menor quantidade de polímero, tiverem um indicativo de comportamento de fluido newtoniano, diferente dos demais, o que pode não ser desejado para esse tipo de forma farmacêutica tópica e semi-sólida. Ao final desse trabalho, pode-se concluir que foi possível desenvolver um sistema farmacêutico na forma de dispersão sólida com maior solubilidade que a NYS pura, e sua incorporação em uma forma farmacêutica mucoadesiva, e que a liberação da NYS na forma DS foi muito superior que o fármaco na forma "convencional", o que permite que a NYS esteja mais disponível na cavidade oral, e também junto à mucosa bucal, o que levaria a efeito farmacológico mais efetivo do antifúngico

Nystatin (NYS) is the drug of first choice in the treatment of oral candidiasis that most often affect immunocompromised individuals, and patients with other disorders. In the Brazilian market, NYS is found in the form of aqueous oral suspension, a medication used in the form of mouthwash. Although there is an indication to maintain direct contact between the drug and the oral mucosa, where Candida spp. is found, as well as where therapeutic success would significantly be increased, the suspension has no such property. Thus, the NYS is an effective drug against oral candidiasis, and belongs to Class IV of the Biopharmaceutical Classification System, it has low solubility and low permeability. The low solubility can compromise its availability in the oral cavity, and consequently, its pharmacological action. Given this situation, the objective of this work was the development of solid dispersions of NYS for the treatment of oral candidiasis, and its subsequent incorporation into oral mucoadhesive gel, in order to facilitate its action. Solid dispersions are pharmaceutical systems, in which a solid drug poorly soluble in water is dispersed in a carrier. These carriers are usually hydrophilic, and this allows the systems to be employed in order to increase the aqueous solubility of the drug. Thus, the solid NYS dispersions were developed by the solvent evaporation method, employing lactose, HPMC, poloxamer 407 and poloxamer 188 as carrier. These samples were subjected to characterization by thermal analysis, using differential scanning calorimetry (DSC) and thermogravimetry / derivative thermogravimetry (TG / DTG). Among these solid dispersions, those samples which showed a specific thermal behavior suggesting the formation of new "system" were analyzed by solubility test. Thus, the NYS DS G2 formulation (49) stood out, once it showed greater solubility in water (4.484 mg/mL); at pH 5.5 (4.249 mg/mL) and pH 7.0 (4.293 mg/mL), in other words, an increase of 1,426 times in water; 4,227 times at pH 5.5; and 2,743 times at pH 7.0. This formulation was finally evaluated by X-ray diffraction, infrared spectroscopy with Fourier transform, techniques that corroborate the thermal analysis, indicating the formation of the solid dispersion. On the other hand, this solid dispersion was incorporated into 4 Carbopol ® 934 PNF mucoadhesive gels, with a variation of the polymer concentration. It was observed that NYS is improved of delivery from the gels, employing mucoadhesion test, and was also observed that the gels have mucoadhesive properties consistent with reports in the literature. However, the rheological characteristics are different, and it was observed that the Gel A and Gel B formulations, which has a lower amount of polymer behaved as a Newtonian fluid, which may not be desired for this type of topical gel. As conclusion, it was possible to develop a pharmaceutical system in the form of solid dispersion with greater solubility than the pure NYS, and their incorporation in a mucoadhesive dosage form and the release of NYS as DS was far superior wherein the drug in the "conventional" manner, which allows the NYS is longer available in the oral cavity, and also adjacent to the buccal mucosa, leading to more effective pharmacological effect of the antifungal agent

Clinical effect of different doses of low concentrations nystatin on moderate thrush in children / 中国生化药物杂志

Objective To study the clinical effect of different doses of low concentrations nystatin on moderate thrush in children.Methods 90 cases of moderate thrush in children from February 2013 to February 2016 in zhejiang xiaoshan hospital were selected, and were divided into the high-dose group (n=45) and the low-dose group (n=45) according to random number table,the high-dose group was treated with 200 thousands U/mL nystatin solution,the low-dose group was treated with 100 thousands U/mL nystatin solution.The treatment effect,adverse reactions and relapse,of two groups were compared.Results On the 3rd and 7th day after treatment,the levels of salivary sIgA in two groups were increased (P<0.05),the level of sIgA in saliva decreased at 15 and 30 days after treatment (P <0.05),the levels of sIgA in saliva at 3,7,15,and 30 days after treatment were significantly higher in the high-dose group than in the low-dose group;The time of improvement of clinical symptoms,the disappearance time of clinical symptoms,the weak positive time of laboratory examination and the negative time of laboratory examination in high dose group were all lower than in low-dose group (P<0.05);the total effective rate in high dose group was 95.56%which was significantly higher than low dose group 75.56%(P<0.05). In the process of the treatment,there was no significant difference between the two groups in the incidence of adverse reactions.Follow-up of three months,the recurrence rate of high-dose group was 2.22%,which was significantly lower than that of low-dose group 15.56% (P<0.05).Conclusion Compared with the conventional low-dose,high-dose low concentrations nystatin treatment of moderate thrush in children with more significant effect,the adverse reactions and recurrence rate are low.

Compare the nursing effects of 3 kinds of collutory for patients with chronic obstructive pulmonary diseases when combined with oral fungal infection / 中国实用护理杂志

Objective To compare the efficacy of three solutions used in the patients who suffered chronic obstructive pulmonary diseases (COPD ) when combined with oral fungal infection,and to find the most suitable one. Methods Using randomized controlled trial method, 98 patients who suffered COPD complicated with fungal infection were randomly divided into three groups. Method 1, using 0.5% povidone for the oral care. Method 2, making 200 million U of nystatin powder dissolved in 2.5% NaHCO3 for the oral care.Method 3, gave oral care with 2.5% NaHCO3 first, then put 200 million U of nystatin powder into 20 ml glycerol and covered the oral spots with them. Three groups were observed in the effect of oral fungal infection and the feedback from patients and nurses. Results In the analysis of the white spots sharply disappeared or pharyngeal swab smear turned negative, method 1 and method 3 had no statistical difference, P>0.05, but method 2 and method 3 had statistical significance, t=3.892, P 0.05. The time made solution of method 1 occupied 41.7% of method 3, and the time made solution of method 2 occupied 54.4%of method 3, while there was no statistical significance in total time of three groups (P>0.05). Conclusions The oral care with 0.5% povidone had good effect on the patients who suffered COPD complicated with oral fungal infection,with good comfort,and most nurses saving time. Nystatin powder dissolved in 2.5% NaHCO3 worked later than nystatin powder dissolved in glycerol.

Randomized, single-blinded comparison of efficacy, safety and tolerability of metronidazole 750mg - miconazole 200mg vaginal suppository vs. metronidazole 500mg - nystatin 100, 000 IU vaginal suppository in the treatment of bacterial vaginosis, vulvovaginal candidiasis, trichomoniasis, and mixed vaginal infections / Philippine Journal of Obstetrics and Gynecology

OBJECTIVE: This randomized, single-blind, two-arm controlled study compared the efficacy, safety, and tolerability of an intravaginal suppository preparation containing metronidazole 750mg + miconazole 200mg (Neopenotran Forte) with another vaginal preparation containing metronidazole 500 mg + nystatin 10000 IU (Flagystatin) in the treatment of bacterial vaginosis (BV), candidal and trichomonial vulvovaginitis (CVV, TV), mixed vaginitis and in the prevention of secondary candidal vulvovaginitis. MATERIALS AND METHODS: Women ages 18-45 years with chief complaints of abnormal vaginal discharge or vaginal/vulvar itching were examined and microbiologic confirmation of BV, VVC, TV or mixed infection was made. They were then randomly assigned to receive either treatment once daily (nightly) for 7 days. A total of 261 subjects had evaluable clinical and microbiological findings at the end of the study. Test of cure by Amsel criteria and Nugent score were performed twice after treatment. RESULTS: The overall test revealed that microbiological cure rate is significantly different between the two treatment groups. CONCLUSION: The odds of being cured microbiologically is 2.35 times more in the metronidazole 750mg + miconazole nitrate 200mg group compared to the metronidazole 500 mg + nystatin 10000 IU group. However, no significant difference in the clinical cure between the two groups was found. Both drugs are safe and convenient to use.

Formulation and Characterization of Nystatinloaded Nanostructured Lipid Carriers for Topical Delivery against Cutaneous Candidiasis.

Aims: The objective of the current study was to formulate nystatin (Nyst) into nanostructured lipid carriers (NLCs) to enhance its antifungal activity. Place and Duration of Study: Department of pharmaceutical technology, national research centre, Egypt, between mars 2011 to april 2013 Methodology: Nyst loaded NLCs (NYST-NLCs) were prepared by the hot homogenization and ultrasonication method followed by evaluation of its topical effect on the cutaneous candidiasis. The prepared Nyst-NLCs were characterized for entrapment efficiency, particle size, zeta potential, morphology (transmission electron microscopy), thermal characterisation (differential scanning calorimetry) and in vitro drug release. The study design involves the investigation of the effect of three independent variables namely liquid lipid type (Miglyol 812 and Squalene), liquid lipid concentration (30 and 50%) and Nyst concentration (0.125 and 0.25%). A stability study for 6 months was performed. A microbiological study was conducted in male rats infected with Candida albicans. Results: NLC dispersions were spherical in shape with particle size ranging from 68.06±6.56 to 141.8±3.33 nm. The entrapment efficiencies ranged from 45.50±2.34 to 92.73±0.33% with zeta potential ranging from -26.2 to -39.2 mV. The stability studies done for 6 months indicated that Nyst-NLCs were stable for more than 6 monthes.the microbiological studies showed A least number of colonies forming units (cfu/ml) were recorded for the selected Nyst-NLCs compared to the drug solution and the Nystatin® cream present in the market. Conclusion: It can be fulfilled from this work that NLCs represent promising carrier for topical delivery of Nyst offering good physical stability, high entrapment efficiency and controlled drug release. Nyst-NLCs are a good candidate for cutaneous treatment of fungal infection.