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Efficacy of clotrimazole for the management of oral candidiasis: A meta-analysis of randomized clinical trials
- Source :
- Saudi Pharmaceutical Journal : SPJ
- Publication Year :
- 2021
- Publisher :
- Elsevier, 2021.
-
Abstract
- Purpose To assess the efficacy and safety of topical application of clotrimazole versus others in the treatment of oropharyngeal candidiasis (OPC). Method Four electronic databases, registries of ongoing trials, and manual search were used to identify randomized controlled trials (RCTs) that compared the efficacy of clotrimazole to other antifungal agents in patients who were clinically diagnosed with oral candidiasis up to November 1st, 2019. Primary outcomes were clinical response and mycological cure rates. Secondary outcomes include relapse rate, incidence of systemic infections, and compliance. Adverse effects were also evaluated. Results Sixteen RCTs with a total of 1685 patients were included. Half of the eligible studies were considered at high risk of performance bias and more than a third, at high risk of reporting bias. Our analysis showed no significant difference in clinical response between clotrimazole and all other antifungal agents. However, clotrimazole was less effective in terms of mycologic cure and relapse rate. Sensitivity analysis comparing clotrimazole to other topical antifungal agents only showed no differences in clinical response, microbiologic cure or relapse. Further sensitivity analysis showed significant efficacy of fluconazole over clotrimazole. Conclusion This meta-analysis indicated that clotrimazole is less effective than fluconazole but as effective as other topical therapies in treating OPC. Well-designed high-quality RCT is needed to validate these findings.
- Subjects :
- medicine.medical_specialty
Pharmaceutical Science
Oropharyngeal Candidiasis
law.invention
03 medical and health sciences
0302 clinical medicine
OPC, oropharyngeal candidiasis
Randomized controlled trial
law
Internal medicine
Medicine
030212 general & internal medicine
Clotrimazole
Adverse effect
Pharmacology
business.industry
Incidence (epidemiology)
030206 dentistry
CI, confidence interval
HIV, human immunodeficiency virus
OR, odds ratio
Meta-analysis
Reporting bias
Oral candidiasis
Systematic review
Original Article
business
Fluconazole
medicine.drug
Subjects
Details
- Language :
- English
- ISSN :
- 22137475 and 13190164
- Volume :
- 29
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- Saudi Pharmaceutical Journal : SPJ
- Accession number :
- edsair.doi.dedup.....f072049856afcb20ee070afef3a4c593