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Miconazole in oral candidiasis
254
Journal of Dentistry, Vol. ~/NO. 3
PHARMACOLOGY CULLITON
AND THERAPEUTICS
6. J.
Drug resistance growing worse, Dent Absrr. 22 (1977) 1%. There are fears that penicillin-resistant gonococci may spread their anti-penicillin enzymes to other organisms such as meningococci. Resistance is transferred from organism to organism by packages of genes called R-factors. By a process of conjugation, R-factors pass from bacterium to bacterium, transferring genetic information in aclassic, natural case of recombinant DNA. Antibiotic usageshould be limited severely. Andrew Richardson BRINCKER
H.
Miconazole in oral candidiasis, Proc. R. Sot. Med. 70 (1977) Suppl. 1. Treatment with antibiotics, cytostatics and corticosteroids has been considered to be responsible for the steadily increasing number of systemic fungal infections observed during the past 20 years, especially in patients with leukaemia. The author started using miconazole topically in the form of tablets for the treatment of oral candidiasis in August 1972. The preliminary results indicated a high rate of clinical cure in a very few days. Patients undergoing chemotherapy for leukaemia, lymphoma or a solid tumour who had clinically obvious oral candidiasis (verified by positive cultures of Candida albicans from the oral mucosa) were observed in this study. The treatment was given as 1 tablet of 250 mg of miconazole four times daily, allowed to dissolve slowly in the mouth. After gradual dissolution of the tablet, the drug was swallowed. Removable dentures, if any, were placed in 150 ml of water in which 1 tablet of miconazole was dissolved. The dentures were treated for at least 1 hour simultaneously with the oral application of the drug. The protocol prescribed the treatment to be continued for at least 2 days after clinical cure of the candidiasis. Mycological cure was established by a negative culture from the oral mucous membrane on the day after the end of miconazole treatment. Thirty-five episodes of oral candidiasis were treated in 24 patients. The median
age of the patients was 55 years, and all the patients were strongly predisposed to fungal infections because of granulocytopenia or simultaneous treatment with prednisolone or antibiotics. Clinical cure was observed in all 35 cases, the mean treatment time being 5 days, thus clinical cures were obtained in 2-3 days. In many cases even heavy disseminated fungal coatings disappeared after only 1 day of treatment. The mean disease-free interval between attacks of fungal infection was 14 days (while the patients remained predisposed to fungal infection to the same degree). Compared with studies of nystatin and amphoteracin B, miconazole givesthe highest frequency of clinical and mycological cure in spite of the shortest treatment time. This is probably because miconazole is absorbed from the gastro-intestinal tract. The tablets used in this study had an unpleasant taste; however, this has now been eliminated, and there are no other side-effects ascribable to miconazole. P. A. E. Banks MUMFORD
J. S.
Transcutaneous neural stimulation for relief of orofacial pain, Dent. Abstr. 22 (1977) 105. Electrical stimulators where the amplitude, frequency and duration of the stimulus can be regulated by the patient are available. One electrode is applied to the painful area and the other is applied wherever is convenient. The current amplitude is increased until the patient feels a ‘satisfying’ sensation in the painful area. When this sensation fades, the patient again adjusts the amplitude. Andrew Richardson
RESEARCH AND CLINICAL ENNEVER J.,VOGEL and PAOLOSKI F. B.
PRACTICE
J. J., RIGGAN
L. J.
Proteolipid and celculus matrix calcification in vitro, J. Dent Res. 56 (1977) 140142. Total lipid derived from pooled calculus samples was separated into crude phospholipid and non-polar lipid by acetone precipitation.
Journal of Dentistry, Vol. ~/NO. 3
PHARMACOLOGY CULLITON
AND THERAPEUTICS
6. J.
Drug resistance growing worse, Dent Absrr. 22 (1977) 1%. There are fears that penicillin-resistant gonococci may spread their anti-penicillin enzymes to other organisms such as meningococci. Resistance is transferred from organism to organism by packages of genes called R-factors. By a process of conjugation, R-factors pass from bacterium to bacterium, transferring genetic information in aclassic, natural case of recombinant DNA. Antibiotic usageshould be limited severely. Andrew Richardson BRINCKER
H.
Miconazole in oral candidiasis, Proc. R. Sot. Med. 70 (1977) Suppl. 1. Treatment with antibiotics, cytostatics and corticosteroids has been considered to be responsible for the steadily increasing number of systemic fungal infections observed during the past 20 years, especially in patients with leukaemia. The author started using miconazole topically in the form of tablets for the treatment of oral candidiasis in August 1972. The preliminary results indicated a high rate of clinical cure in a very few days. Patients undergoing chemotherapy for leukaemia, lymphoma or a solid tumour who had clinically obvious oral candidiasis (verified by positive cultures of Candida albicans from the oral mucosa) were observed in this study. The treatment was given as 1 tablet of 250 mg of miconazole four times daily, allowed to dissolve slowly in the mouth. After gradual dissolution of the tablet, the drug was swallowed. Removable dentures, if any, were placed in 150 ml of water in which 1 tablet of miconazole was dissolved. The dentures were treated for at least 1 hour simultaneously with the oral application of the drug. The protocol prescribed the treatment to be continued for at least 2 days after clinical cure of the candidiasis. Mycological cure was established by a negative culture from the oral mucous membrane on the day after the end of miconazole treatment. Thirty-five episodes of oral candidiasis were treated in 24 patients. The median
age of the patients was 55 years, and all the patients were strongly predisposed to fungal infections because of granulocytopenia or simultaneous treatment with prednisolone or antibiotics. Clinical cure was observed in all 35 cases, the mean treatment time being 5 days, thus clinical cures were obtained in 2-3 days. In many cases even heavy disseminated fungal coatings disappeared after only 1 day of treatment. The mean disease-free interval between attacks of fungal infection was 14 days (while the patients remained predisposed to fungal infection to the same degree). Compared with studies of nystatin and amphoteracin B, miconazole givesthe highest frequency of clinical and mycological cure in spite of the shortest treatment time. This is probably because miconazole is absorbed from the gastro-intestinal tract. The tablets used in this study had an unpleasant taste; however, this has now been eliminated, and there are no other side-effects ascribable to miconazole. P. A. E. Banks MUMFORD
J. S.
Transcutaneous neural stimulation for relief of orofacial pain, Dent. Abstr. 22 (1977) 105. Electrical stimulators where the amplitude, frequency and duration of the stimulus can be regulated by the patient are available. One electrode is applied to the painful area and the other is applied wherever is convenient. The current amplitude is increased until the patient feels a ‘satisfying’ sensation in the painful area. When this sensation fades, the patient again adjusts the amplitude. Andrew Richardson
RESEARCH AND CLINICAL ENNEVER J.,VOGEL and PAOLOSKI F. B.
PRACTICE
J. J., RIGGAN
L. J.
Proteolipid and celculus matrix calcification in vitro, J. Dent Res. 56 (1977) 140142. Total lipid derived from pooled calculus samples was separated into crude phospholipid and non-polar lipid by acetone precipitation.