A Cochrane review [Abstract] 1 included 22 trials with a total of 2 755 participants. None of the studies investigated the effects of HAART or any other form of antiretroviral treatment on oropharyngeal candidiasis (OC). Fluconazole favoured clinical cure in adults compared to nystatin (RR 1.69, 95% CI 1.27 to 2.23, 1 RCT, n=167). Both gentian violet (RR 5.28; 95% CI 1.23 to 22.55, 1 RCT, n=96) and ketoconazole (RR 5.22; 95% CI 1.21 to 22.53, 1 RCT, n=92) were superior to nystatin in bringing about clinical cure. A single trial compared gentian violet with lemon juice and lemon grass with no significant difference in clinical cure between the groups. There was no difference with regard to clinical cure between fluconazole compared to ketoconazole (RR 1.27; 95% CI 0.97 to 1.66, 2 RCTs, n=83), itraconazole (RR 1.05; 95% CI 0.94 to 1.16, 2 RCTs, n=434), clotrimazole (RR 1.14; 95% CI 0.92 to 1.42, 2 RCTs, n=358), or posaconazole (RR 1.32, 95% CI 0.36 to 4.83; 1 RCT, n=366). Two trials compared different dosages of fluconazole with no difference in clinical cure. When compared with clotrimazole, both fluconazole (RR 1.47; 95% CI 1.16 to 1.87, 2 RCTs, n=358) and itraconazole (RR 2.20; 95% CI 1.43 to3.39, 1 RCT, n=123) proved to be better for mycological cure.
Comment: The quality of evidence is downgraded by study quality (unclear allocation concealment and high loss to follow-up in some studies) and by imprecise results (limited study size for each comparison).
Primary/Secondary Keywords