Effects of lawsone methyl ether mouthwash on oral Candida in HIV-infected subjects and subjects with denture stomatitis

ObjectivesTo determine (i) effects of lawsone methyl ether (LME) mouthwash on antifungal drug resistance of oral Candida, (ii) effects of LME mouthwash on changes in genotype of oral Candida, and (iii) allergy and subjects' satisfaction on LME mouthwash in comparison with chlorhexidine (CHX). Materials and methodsA randomized clinical trial was conducted in HIV-infected subjects and denture wearers receiving either LME or CHX mouthwash. Candidal culture by oral rinse technique was performed as baseline and after using the mouthwash for 2weeks. Antifungal drug resistance and changes in genotype of oral Candida were assessed by microdilution assay, inverted repeat polymerase chain reaction and restriction fragment length polymorphism assays, respectively. Allergy and subjects' satisfaction on the mouthwashes were recorded. Statistical analysis was performed using Chi-squared and Fisher's exact tests. ResultsTwenty-nine HIV-infected subjects (age range, 26-54years; mean age, 41years) and 38 denture wearers (age range, 27-76years; mean age, 55years) were enrolled. C.albicans was the most common specie found in both groups followed by C.tropicalis, C.parapsilosis, and C.glabrata. Neither antifungal drug resistance nor significant changes in genotyping of Candida were noted among those receiving LME mouthwash. Subjects' satisfaction on taste and smell of LME mouthwash was comparable to that of CHX. ConclusionsUse of LME mouthwash for 2weeks neither led to antifungal drug resistance nor significant changes in genotype of oral Candida. Thus, LME may be an alternative mouthwash in prophylaxis of oral candidiasis among those at risk of developing the disease.