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13.
Systematic review and meta-analysis of different antifungals in the treatment of oral candidiasis [Elektronski vir] : Master's Degree in Pharmaceutical Sciences
Mendonça Vidal Meireles, Sofia
Oral fungal infection caused by Candida species, called oral candidiasis can affect any person at any stage of life. Immunocompromised individuals are more likely to develop these infections which ...worsen their condition by decreasing food intake, increasing susceptibility to other infections and weakening the all body condition. Prevention through hygiene and primary care can prevent recurrence and treatment and it can be the key to maintaining oral health and consequently ensuring the quality of life of the population. The aim of the systematic review integrated in the meta-analysis was to compare the effectiveness of antifungals tested in different populations by combining their relative risks for treatment effects (i.e. clinical or mycological cure). The search strategy in this systematic review was performed in the following electronic databases: Cochrane Library, PubMed and Nature. This systematic review included 27 comparative studies of antifungal efficacy in treating oral candidiasis in different types of populations from children to the elderly, individuals with HIV, cancer and other immunological disorders. The data of the articles were extracted and the results of the clinical and mycological response were compared through a meta-analysis in the Review Manager software. An ideal antifungal should offer clinical and mycological cure, without giving significant adverse effects, being low cost and preventing the emergence of resistance. Fluconazole showed significant efficacy when compared to itraconazole, nystatin, clotrimazole and ketoconazole for clinical response. Referring to mycological response, fluconazole showed statistically superior results when compared to itraconazole, nystatin and clotrimazole. In an article published in 2015, isavuconazole showed significant clinical cure when compared with fluconazole, which could represent an alternative to this in case of resistance. Laboratory and clinical research should be continued in order to obtain more updated studies and combat this public health problem.
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