Value of antifungal prophylaxis with antifungal drugs against oropharyngeal candidiasis in cancer patients.

This report focuses on the value of antifungal prophylaxis with antifungal drugs in preventing oropharyngeal candidiasis. Randomised trials comparing non-AIDS immunocompromised patients receiving or not an oral antifungal agent were reviewed. Colonisation of the throat with Candida albicans is a risk factor, principally when cultures for this species of yeasts remain positive after initiation of the prophylaxis. The results of the trials were meta-analysed and we obtained a combined odds ratio for developing oropharyngeal candidiasis of 0.15 when under antifungal prophylaxis (confidence interval at 95%:0.10-0.22, chi 2 statistic of 90.77, P < 0.0001). We conclude that there is a strong beneficial effect of antifungal prophylaxis against the occurrence of oropharyngeal candidiasis. However, up to now, no study has correctly assessed the value of nystatin as a prophylactic agent against oropharyngeal candidiasis.