Assessment of oral candidiasis in patients with respiratory disease and efficacy of a new nystatin formulation.

Fifty consecutive patients with respiratory diseases who developed oropharyngeal candidiasis were assessed clinically and microbiologically before and after seven days' treatment with nystatin suspension or pastilles (a new formulation). In 45 patients in whom microbiology yielded positive results there was frequent associated use of oral corticosteroids, antibiotics, sedatives, and inhaled corticosteroid, while in a few patients atropine analogues may have predisposed to infection. Dentures were worn by 32 of the infected patients. Concomitant treatment of dentures in chronically infected patients appeared to improve the therapeutic response. Pastilles and suspension were equally efficacious both clinically and microbiologically. The potential for enhanced drug delivery to the oropharynx suggests that nystatin pastilles may be useful in patients in whom poor compliance seems likely.