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Evaluation and comparison of antifungal effect of voriconazole with nystatin on candida species derived from neoplastic patients undergoing maxillofacial radiotherapy
Faezeh Khozeimeh1, Zahra Golestan Nezhad1, Parvin Dehghan2, Adel Tabesh1, Mahnaz Kheirkhah3, Mina Jamshidi4, Ahmad Amiri Chermahini5, Leila Sadeghalbanaei6, Zahra Golestannejad1
1 Department of Oral and Maxillofacial Medicine, Dental Research Center, School of Dentistry, Dental Research Institute, Isfahan University of Medical Science, Isfahan, Iran
2 Department of Mycology and Parasitology, Faculty of Medicine, Isfahan University of Medical Science, Isfahan, Iran
3 Department of Mycology and Parasitology, School of Medicine, Isfahan University of Medical Science, Isfahan, Iran
4 Department of Periodontology, School of Dentistry, Isfahan University of Medical Science, Isfahan, Iran
5 Department of Endodontics, Student Research Committee, Qazvin University of Medical Science, Qazvin, Iran
6 Department of Orthodontics, School of Dentistry, Isfahan University of Medical Science, Isfahan, Iran
Correspondence Address:
Dr. Ahmad Amiri Chermahini
Department of Endodontics, Student Research Committee, Qazvin University of Medical Science, Qazvin
Iran
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/1735-3327.382132
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Background: Radiotherapy is a common treatment for head-and-neck malignancies and causes complications such as oral candidiasis and the change of oral Candida species from albicans to nonalbicans. Voriconazole has acceptable antifungal effect. The aim of this study was to determine and compare the antifungal effect of nystatin with voriconazole on these species.
Materials and Methods: The samples used in this in vitro study were identified by polymerase chain reaction-restriction fragment length polymorphism from patients before and 2 weeks after head-and-neck radiotherapy in Seyed Al-Shohada Hospital. The antifungal effect of nystatin and voriconazole was determined by microdilution method and measurement of the minimum inhibitory concentration (MIC) and the minimum fungicidal concentration, and the results were analyzed by Mann–Whitney analysis.
Results: The results showed that all species before and after radiotherapy showed 100% sensitivity to nystatin. Prior to radiotherapy, 57.1% of albicans species isolated were in the sensitive range (MIC ≤1) and 42.9% were in the dose-dependent range (MIC = 2) to voriconazole. After radiotherapy, 58.3% of albicans species were in the sensitive range and 41.7% of these species were in the dose-dependent range to voriconazole.
Conclusion: The results of the present study showed that before radiotherapy, all species were sensitive to nystatin, while a percentage of albicans and nonalbicans were resistant to voriconazole. In the 2nd week of radiotherapy similar to prior to radiotherapy, all species isolated from patients were sensitive to nystatin, while a percentage of albicans and nonalbicans were resistant to voriconazole.
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