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Evaluation of antifungal effect of amphotericin B in comparison with nystatin on Candida species derived from patients undergoing head-and-neck radiotherapy

Summary

This study compared two antifungal medications (nystatin and amphotericin B) for treating oral yeast infections in cancer patients receiving head-and-neck radiotherapy. Researchers tested how well each drug worked against different Candida yeast species before and during radiation treatment. The results showed that nystatin was more effective than amphotericin B at killing the yeasts, with nystatin working against all yeast species tested, while amphotericin B had reduced effectiveness against some Candida albicans strains.

Background

Radiotherapy for head-and-neck cancer increases the incidence of oral candidiasis through alterations in saliva composition and volume. There has been a shift from Candida albicans to non-albicans species, with emerging resistance to nystatin. Amphotericin B is a polyene antifungal with potential superior efficacy against fungal species compared to routine antifungals.

Objective

This study aimed to compare the antifungal effects of nystatin and amphotericin B on Candida species isolated from patients before and during head-and-neck radiotherapy, evaluating minimum inhibitory concentrations and resistance patterns.

Results

Before radiotherapy, 100% of all Candida species (C. albicans, C. tropicalis, C. glabrata) were sensitive to nystatin, while 71.4% of C. albicans were sensitive to amphotericin B. After radiotherapy, sensitivity to nystatin remained 100% across all species, while C. albicans sensitivity to amphotericin B was 75%. Nystatin demonstrated significantly higher antifungal efficacy than amphotericin B across both timepoints.

Conclusion

The study demonstrated that nystatin has greater antifungal effect than amphotericin B against Candida species both before and after head-and-neck radiotherapy. All tested species maintained 100% sensitivity to nystatin, while some C. albicans strains showed resistance to amphotericin B, suggesting nystatin remains the superior treatment option for oral candidiasis in radiotherapy patients.
  • Published in:Dental Research Journal (Isfahan),
  • Study Type:In vitro experimental study,
  • Source: PMID: 39802813
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