Comparison of the efficacy of fluconazole tablet and oral nystatin suspension in the treatment of oral candidiasis in HIV/AIDS patients seen in Dalhatu Araf Specialist Hospital (DASH), Lafia

Abstract

Background: Oral candidiasis is the most common HIV/AIDs related complication. It limits patients from feeding and interferes with the intake of HAART, as the patients find it difficult to swallow food and their medications. It leads to poor adherence, poor feeding, depression, loss of man hours, deterioration of patient's state of health and consequently death.

Materials and methods: The study was a randomized control single blinded clinical trial to compare the efficacy of Fluconazole tablet with oral Nystatin suspension in the treatment of oral candidiasis. The study was conducted between 15th September 2012 and 15th January, 2013 at DASH Lafia. The study participants were randomized into two groups after they met the inclusion criteria. The intervention group received Fluconazole, while the control group received Nystatin suspension. Subjects were followed-up weekly until they achieved clinical and laboratory cure. A total of 72 pre-tested questionnaires were used. Information sought included, socio-demographic characteristics, Baseline information, duration and cost of cure. Sixty two well completed questionnaires were analyzed using SPSS 2010.

Results: The cure rate for Fluconazole was 77.4 % after two weeks and 100 % after four weeks. The cure rate for Nystatin suspension was 45.2 % after two weeks and 71.0 % after four weeks, 29.0 % of the subjects in the Nystatin group had treatment failure at the end of the four weeks of study. There was no treatment failure in the Fluconazole group. Bivariate analysis showed significant statistical difference in the efficacy of Fluconazole tablet over Nystatin suspension in the treatment of oral candidiasis. Fluconazole was also four times more likely to achieve cure than oral Nystatin suspension (P, 0.002, OR 3.7).

Conclusion: Fluconazole should be used as a first line medication in the treatment of oral candidiasis among patients living with HIV/AIDS in this facility and elsewhere were Nystatin is still in use.

Keywords: Efficacy, Cure rate, Fluconazole, Nystatin, HIV/AIDs, Oral candidiasis