Impact of Nystatin Oral Rinse on Salivary and Supragingival Microbial Community among Adults with Oral Candidiasis

This study aimed to evaluate the impact of Nystatin oral rinse on salivary and supragingival microbiota in adults with oral candidiasis and identify predictive factors related to individuals' responses to Nystatin. The trial involved twenty participants who used 600,000 International Units/application of Nystatin oral rinse for seven days, four times a day, and were followed up at one week and three months after the rinse. The salivary and plaque microbiome of the participants were assessed via 16S rDNA amplicon sequencing. Overall, salivary and plaque microbiomes remained stable. However, among the participants (53 percent) who responded to Nystatin rinse (defined as free of oral Candida albicans post treatment), Veillonella emerged as a core genus alongside Streptococcus and Actinomyces in supragingival plaque at the 3-month follow-up. Furthermore, statistical models were fit to identify predictive factors of Nystatin rinse success (elimination of C. albicans) or failure (remaining C. albicans). The results revealed that an increased level of salivary Interferon (IFN)-& gamma;-inducible protein (IP-10), also known as C-X-C motif chemokine ligand 10 (CXCL10), was an indicator of a failure of responding to Nystatin rinse. Future clinical trials are warranted to comprehensively assess the impact of antifungal treatment on the oral flora.

Automated summary

This study evaluated the effects of Nystatin oral rinse on the oral microbiota of adults with oral candidiasis and identified predictive factors for the response to Nystatin. Twenty participants used Nystatin oral rinse for seven days and were followed up after one week and three months. The results showed that the salivary and plaque microbiomes remained stable overall, but a specific genus, Veillonella, emerged in the supragingival plaque after three months in participants who responded well to Nystatin. Additionally, an increased level of salivary Interferon (IFN)-& gamma;-inducible protein (IP-10) was associated with a lack of response to Nystatin rinse.