Evaluation of nystatin in prevention and elimination of oropharyngeal Candida in immunosuppressed patients.

Thirty-three patients with acute leukemia or lymphoma received an ongoing topical treatment with an oral suspension of nystatin during prolonged periods of intensive chemotherapy and severe granulocytopenia. The preparation proved ineffective in eliminating colonized Candida species from the oropharynx in ten of eleven patients at the time of admission and was of questionable value in preventing later colonization in others. The difficulties surrounding the identification of systemic candidiasis, its significance in the immunosuppressed patient, and the role of topical antifungal prophylaxis are discussed.