Cochrane · intervention · CD001972
Interventions for treating oral candidiasis for patients with cancer receiving treatment
Worthington, HV, Clarkson, JE, Khalid, T, et al. · Cochrane Database of Systematic Reviews · 2010 · Cochrane Library
Full textEvery question was extracted from the full review (methods and results), not only its Summary of Findings table.
Questions
22
current version
GRADE rated
0
No studies
9
Included studies
10
as reported
No studies 9 · 40.9%Ungraded 13 · 59.1%Very low 0 · 0%Low 0 · 0%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Anyone with cancer who received chemotherapy or radiotherapy or both and had overt oral candidiasis | 940 patients across 10 included trials; six trials adults only, one adults and children, one children only, two unclear age; cancer types leukaemias and solid tumours in seven trials, head and neck cancer in two, unspecified childhood malignancies in one |
| Intervention | Any antifungal intervention for the treatment of oral candidiasis | Fluconazole (n=5); Ketoconazole (n=3); Itraconazole (n=2); Clotrimazole (n=2); Miconazole (n=1); Amphotericin B (n=1); Nystatin (n=2) |
| Comparison | Placebo/No treatment/Another active intervention | Placebo (n=2); Active comparators (n=8) |
| Outcomes | Oral candidiasis (absent or present); Relief of pain; Amount of analgesia; Relief of dysphagia; Incidence of systemic infection; Days stay in hospital; Cost of oral care; Patient quality of life | Eradication of oral candidiasis clinical (n=10); Eradication of oral candidiasis mycological (n=9); Relief of pain (n=3); Relief of dysphagia (n=3); Side effects (n=3) |
| Study designs | Randomised controlled trials | 10 RCTs; only 1 of 10 assessed at low risk of bias |
| Timing | Not specified | Not specified |
Search date: 2010-06. Databases: Cochrane Oral Health Group Trials Register; Cochrane Pain, Palliative and Supportive Care (PaPaS) Group Trials Register; Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE via OVID; EMBASE via OVID; CINAHL via EBSCO; CANCERLIT via PubMed; OpenSIGLE; LILACS via the Virtual Health…
Questions and results
Show all 4 versionsKetoconazole (absorbed from GI tract) vs Placebo
Population: Patients with cancer receiving chemotherapy and/or radiotherapy with overt oral candidiasis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mycological: eradication of oral candidiasis | RR 5.09 [0.73, 35.49] | 1 study · 47 participants | Ungraded |
Clinical: eradication of oral candidiasis | RR 3.61 [1.47, 8.88] | 1 study · 56 participants | Ungraded |
Clotrimazole (partially absorbed from GI tract) vs Placebo
Population: Patients with cancer receiving chemotherapy and/or radiotherapy with overt oral candidiasis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mycological: eradication of oral candidiasis | RR 6.13 [0.38, 99.14] | 1 study · 13 participants | Ungraded |
Clinical: eradication of oral candidiasis | RR 3.43 [0.51, 22.94] | 1 study · 13 participants | Ungraded |
Fluconazole (absorbed from GI tract) vs Itraconazole (absorbed from GI tract)
Population: Patients with cancer receiving chemotherapy and/or radiotherapy with overt oral candidiasis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical: eradication of oral candidiasis | RR 1.14 [1.00, 1.30] | 2 studies · 293 participants | Ungraded |
Mycological: eradication of oral candidiasis | RR 1.17 [1.04, 1.33] | 2 studies · 291 participants | Ungraded |
Absorbed drug (fluconazole or ketoconazole) vs Drug not absorbed from GI tract (amphotericin B or nystatin)
Population: Patients with cancer receiving chemotherapy and/or radiotherapy with overt oral candidiasis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical: eradication of oral candidiasis | RR 1.29 [1.09, 1.52] | 3 studies · 207 participants | Ungraded |
Mycological: eradication of oral candidiasis | RR 1.82 [1.28, 2.57] | 3 studies · 189 participants | Ungraded |
Clotrimazole 50 mg (partially absorbed) vs Clotrimazole 10 mg (partially absorbed)
Population: Patients with cancer receiving chemotherapy and/or radiotherapy with overt oral candidiasis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical: eradication of oral candidiasis | RR 1.00 [0.90, 1.11] | 1 study · 52 participants | Ungraded |
Mycological: eradication of oral candidiasis | RR 2.00 [1.11, 3.60] | 1 study · 52 participants | Ungraded |
Partially absorbed antifungal drug (e.g., clotrimazole, miconazole) vs Absorbed antifungal drug (e.g., fluconazole, ketoconazole, itraconazole)
Population: Patients with cancer receiving chemotherapy and/or radiotherapy with overt oral candidiasis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Outcome NR | There were no trials comparing partially absorbed drugs with either absorbed drugs or drugs not absorbed. | 0 studies | No studies |
Partially absorbed antifungal drug (e.g., clotrimazole, miconazole) vs Drug not absorbed from GI tract (e.g., nystatin, amphotericin B)
Population: Patients with cancer receiving chemotherapy and/or radiotherapy with overt oral candidiasis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Outcome NR | There were no trials comparing partially absorbed drugs with either absorbed drugs or drugs not absorbed. | 0 studies | No studies |
Any antifungal intervention for the treatment of oral candidiasis vs Placebo, no treatment, or another active antifungal intervention
Population: Patients with cancer receiving chemotherapy and/or radiotherapy with overt oral candidiasis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Days stay in hospital | None of the studies reported: relief of pain, relief of dysphagia, incidence of systemic infection, amount of analgesia, days stay in hospital, cost of oral care, patient quality of life. | 0 studies | No studies |
Amount of analgesia | None of the studies reported: relief of pain, relief of dysphagia, incidence of systemic infection, amount of analgesia, days stay in hospital, cost of oral care, patient quality of life. | 0 studies | No studies |
Incidence of systemic infection | None of the studies reported: relief of pain, relief of dysphagia, incidence of systemic infection, amount of analgesia, days stay in hospital, cost of oral care, patient quality of life. | 0 studies | No studies |
Cost of oral care | None of the studies reported: relief of pain, relief of dysphagia, incidence of systemic infection, amount of analgesia, days stay in hospital, cost of oral care, patient quality of life. | 0 studies | No studies |
Relief of dysphagia | None of the studies reported: relief of pain, relief of dysphagia, incidence of systemic infection, amount of analgesia, days stay in hospital, cost of oral care, patient quality of life. | 0 studies | No studies |
Relief of pain | None of the studies reported: relief of pain, relief of dysphagia, incidence of systemic infection, amount of analgesia, days stay in hospital, cost of oral care, patient quality of life. | 0 studies | No studies |
Patient quality of life | None of the studies reported: relief of pain, relief of dysphagia, incidence of systemic infection, amount of analgesia, days stay in hospital, cost of oral care, patient quality of life. | 0 studies | No studies |
Fluconazole (absorbed from GI tract) vs Ketoconazole (absorbed from GI tract)
Population: Patients with cancer receiving chemotherapy and/or radiotherapy with overt oral candidiasis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mycological: eradication of oral candidiasis | RR 0.95 [0.52, 1.72] | 1 study · 37 participants | Ungraded |
Clinical: eradication of oral candidiasis | RR 1.02 [0.72, 1.42] | 1 study · 37 participants | Ungraded |
Miconazole 50 mg tablet (partially absorbed) vs Miconazole 500 mg gel (partially absorbed)
Population: Patients with cancer receiving chemotherapy and/or radiotherapy with overt oral candidiasis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical: eradication of oral candidiasis | RR 1.16 [0.91, 1.47] | 1 study · 282 participants | Ungraded |