FK UNAIR expert measures nystatin resistance in oral candidiasis patients with HIV / AIDS

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Illustration by Feri Fenoria

UNAIR NEWS – Oral candidiasis is one of the first clinical signs of AIDS found in 50% to 95% of patients with HIV / AIDS. The condition is mostly caused by the fungus Candida albicans which is often found in the oral cavity of adults. However, Candida albicans is not the only species that causes candidiasis, there are several other species such as Candida glabrata, Candida krusei, Candida tropicalis, etc.

“According to WHO, the initial treatment of oral candidiasis is that it can be given by topical antifungal agents, such as nystatis, amphotericin B, miconazole, and clotrimazole. However, these agents can be given in cases of uncomplicated oral candidiasis, “explained Dwi Murtiastutik, Dr., Sp.KK (K), FINSDV.

Dwi added that an effective, affordable and often used drug in dealing with oral candidiasis in Indonesia is Nystatin. The drug itself is an antifungal drug used in treating Candida yeast infections in the oral cavity, throat, intestine, and vagina. The appropriate dosages of nystatin are 100,000 U / mL, and 400,000 – 600,000 U / mL for adults for 4 times a day for 7-14 days.

“This drug works by damaging fungal cells and stopping the growth of Candida fungus,” she added.

FK UNAIR lecturer and the team were encouraged to carry out an in vitro test to measure Nystatin resistance in oral candidiasis patients with HIV / AIDS, because there were quite a number of cases from Dr. Soetomo Hospital that experienced symptoms of oral candidiasis repeatedly.

“In 2017, there were 261 out of 1020 patients with HIV / AIDS has oral candidiasis in Dr. Soetomo Hospital in Surabaya. The number increased to 273 patients in 2018. From June to July 2018, there were 20 oral candidiasis patients treated with oral nystatin, but 30% of them returned to the hospital with similar cases, “Dwi said.

Responding to this, Dwi and her team measured the level of Candida fungus resistance in the oral candidiasis of HIV / AIDS patients at RSU Dr. Soetomo. She involved 29 patients, which 23 male patients and 6 female patients, with an age range of 18-65 years. Also, the drugs to be tested are Nystatin and Fluconazole.

“We use two different types of drugs as a comparison,” she said.

Judging from the results of the study, it was stated that precisely the majority of subjects were resistant to Fluconazole, while the majority of subjects were sensitive to Nystatin.

“In the in vitro test, there are no Candida isolates were resistant to Nystatin. “Therefore, oral Nystatin is still effectively used as standard therapy for HIV / AIDS patients with oral candidiasis,” she concluded. (*)

Author: Bastian Ragas

Editor: Nuri Hermawan

Source :

Martiastutik D, Maharani C.S, Listiawan M.Y. 2019. Nystatin Profile on Candida Species in HIV/AIDS Patients with Oral Candidiasis: A Phenomenology Study. J. Pure Appl. Microbiol., 2019, 13 (4): | Article Number: 5749.

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