The influence of antifungal drugs on virulence properties of Candida albicans in patients with diabetes mellitus

Objective. This study investigated the influence of nystatin and fluconazol e on virulence properties of Candida albicans. Study design. A total of 108 diabetic patients participated in the study. E ighty-eight patients had clinical oral candidosis. Drug therapy was given a t 6 hourly intervals for nystatin or daily with fluconazole for a maximum o f 2 weeks. Adhesion of C albicans to buccal epithelial cells was determined by using an autologous adhesion assay prospectively over 6 months. Phospho lipase production was estimated by using an agar plate method. The data ana lysis included a paired Student t test and calculation of correlation coeff icients. Results. Unlike nystatin, treatment with fluconazole reduced the ability of C albicans to colonize the buccal mucosa for up to 8 weeks after the treat ment. Patients without clinical signs of oral candidosis had significantly fewer C albicans isolates producing phospholipase than did patients with or al candidosis. Treatment with fluconazole, but not nystatin, reduced the pr oduction of phospholipase from C albicans oral isolates in patients with di abetes mellitus. Conclusions. In addition to being antifungal, iluconazole alters phospholip ase production, modifies buccal epithelial cells, and reduces adhesion of C albicans to human buccal epithelial cells for up to 8 weeks posttreatment in diabetic patients with oral candidosis.