Article révisé par les pairs
Résumé : Oropharyngeal candidiasis is a common complication in cancer patients, but optimal therapy is still controversial. It remains unclear whether treatment with topical agents is satisfactory or if systemic therapy with ketoconazole is more effective. This study evaluated treatment with nystatin versus ketoconazole and showed simlar success rates (21/24 patients versus 13/18 patients) as well as comparable percentage of patients with eradication of the initial pathogen (66 versus 61%). However, 2 patients treated with nystatin developed a fungaemia caused by Candida albicans. The bitter taste of nystatin precludes its administration in high doses; tolerability and compliance to ketoconazole is usually much better. However, variable individual absorption of ketoconazole and interaction with several medications commonly administered to cancer patients have to be taken into consideration. Overall, systemic therapy of candidiasis seems more beneficial than topical therapy in immunocompromised patients susceptible to deep-seated fungal infections.