Golestannejad Zahra, Dehghan Parvin, Najafizade Nadia, Kheirkhah Mahnaz, Bafrani Maryam Emami, Tabesh Adel, Nadian Farshad, Khozeimeh Faezeh
Department of Oral and Maxillofacial Medicine, Dental Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Mycology and Parasitology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Dent Res J (Isfahan). 2024 Dec 20;21:68. doi: 10.4103/drj.drj_550_23. eCollection 2024.
Head-and-neck radiotherapy can change oral species and lead to the development of refractory oral candidiasis resistant to the commonly prescribed antifungal medications such as fluconazole. Atorvastatin exerts an antifungal effect by inhibiting the synthesis of fungal wall ergosterol and impairing mitochondrial function. This study aimed to compare the antifungal effects of fluconazole and atorvastatin on species isolated from patients undergoing head-and-neck radiotherapy.
In this clinical study, swab samples were collected from 33 patients admitted to Isfahan Seyed-O-Shohada Hospital before the onset and 2 weeks after the initiation of radiotherapy. The antifungal effects of fluconazole and atorvastatin were evaluated by the microdilution test according to the Clinical and Laboratory Standards Institute standards, and measuring their minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC). Data were analyzed by the Mann-Whitney -test and the statistical significance level was considered < 0.05.
The results showed that the MIC24, MIC48, and MFC of fluconazole were significantly lower than those of atorvastatin for , , both before ( < 0.001 for all) and during ( < 0.001 to = 0.003) radiotherapy.
According to the results, fluconazole has antifungal effects comparable to those of atorvastatin, but in much lower doses. Atorvastatin showed optimal antifungal effects but in doses beyond the clinically applicable threshold.
头颈部放疗会改变口腔菌群，并导致对常用抗真菌药物（如氟康唑）耐药的难治性口腔念珠菌病的发生。阿托伐他汀通过抑制真菌细胞壁麦角固醇的合成和损害线粒体功能发挥抗真菌作用。本研究旨在比较氟康唑和阿托伐他汀对从接受头颈部放疗的患者中分离出的菌种的抗真菌效果。
在这项临床研究中，从伊斯法罕赛义德 - 奥 - 肖哈达医院收治的33例患者放疗开始前及放疗开始2周后采集拭子样本。根据临床和实验室标准协会的标准，通过微量稀释试验评估氟康唑和阿托伐他汀的抗真菌效果，并测量它们的最低抑菌浓度（MIC）和最低杀菌浓度（MFC）。数据采用曼 - 惠特尼U检验进行分析，统计学显著性水平设定为<0.05。
结果显示，对于白色念珠菌、热带念珠菌和近平滑念珠菌，在放疗前（所有比较P<0.001）和放疗期间（P<0.001至P = 0.003），氟康唑的MIC24、MIC48和MFC均显著低于阿托伐他汀。
根据结果，氟康唑具有与阿托伐他汀相当的抗真菌效果，但剂量要低得多。阿托伐他汀显示出最佳抗真菌效果，但剂量超出了临床适用阈值。
