Effect of Use of Antifungal (Clotrimazole) Drug in Reducing the Number of Colonies of Candida albicans and Its Correlation with Clinical Candidiasis in the Patients Undergoing Progressive Radiotherapy for the Cervicofacial Region

Aims: To evaluate the effect of topical antifungal Clotrimazole on candida colonies and its correlation with clinical candidiasis in patients undergoing radiotherapy.

Study Design: Randomised Clinical Trial

Place and Duration of Study: Rashtrasant Tukdoji Maharaj Cancer Institute, Nagpur between June 2020 and July 2021.

Methodology: 64 patients (52 males and 12 females) undergoing Co60 teletherapy for cervicofacial malignancies were randomly divided in two groups. 32 patients referred to as study group were put on antifungal treatment (1% Clotrimazole) for topical application and other group was the control group and was not given antifungal medication. During the radiotherapy and 6 weeks after the completion of radiotherapy, patients were examined every week for possible oral changes for clinical candidiasis, and swabs were taken at every end of the week for determining candidal colonies.

Results: The overall incidence of clinical oral candidiasis was 46.9% throughout RT in the control group and there was no incidence of clinical candidiasis in the study group. Patients with clinical candidiasis 6-week post-radiation therapy showed continuous symptoms of clinical candidiasis but with the reduction in candidal colonies.22% of patients were oral carriers for candidal colonies. Also, the study group showed not a single patient with clinical candidiasis.

Conclusion: During radiotherapy, although with the use of clotrimazole some patients with negative culture may also become positive for Candida albicans and there may be some increase in the several colonies of Candida albicans (very less in number as compared to the control group), but its use prevents the development of clinical candidiasis. Antifungal prophylaxis is useful in combating clinical candidiasis.