Probiotics Are Useful For Treating Oral Candidiasis

Oral Candidiasis (“thrush”) is caused by overgrowth of Candida fungi, especially Candida albicans. Oral Candida overgrowth is especially common among babies, the elderly, and the immunocompromised such as HIV and cancer patients.  It has been reported that 15 to 71% of denture wearers and 80 to 95% of HIV infected people have oral candidiasis (1). Anti-fungal drugs such as nystatin, fluconazole, or miconazole can often be useful in treating oral Candida infections, although these drugs can have adverse side effects and Candida strains often develop resistance to them.

Previous studies have reported that oral or topical probiotics can significantly reduce the risk of vulvovaginal candidiasis (2), dermatophytosis (3), and gastrointestinal infections from many bacteria including Clostridium difficile and Heliobacter pylori (4).

The use of oral probiotic bacteria such as Lactobacillus and Bifidobacterium,  can also be useful in controlling growth of oral Candida (1). A meta-analysis of 6 published studies have reported that use of oral probiotics was associated with a 76% reduced risk of oral Candidiasis (OR 0.24, 95% CI 0.09-0.63, p<0.01) (1). Probiotic bacteria used in these studies included Lactobacillus rhamnosus, Lactobacillus acidophilus, Lactobacillus bulgaricus, Bifidobacterium bifidium, Bifidobacterium longum, and Streptococcus thermophiles (1). No serious adverse effects of probiotic usage were noted in these studies.

References

1. Hu L, Zhou M, Young A, Zhao W, Yan Z. In vivo effectiveness and safety of probiotics on prophylaxis and treatment of oral candidiasis: a systematic review and meta-analysis. BMC oral health. 2019;19(1):140.
2. De Seta F, Parazzini F, De Leo R, Banco R, Maso GP, De Santo D, et al. Lactobacillus plantarum P17630 for preventing Candida vaginitis recurrence: a retrospective comparative study. Eur J Obstet Gynecol Reprod Biol. 2014;182:136-9.
3. Kumar S, Mahajan BB, Kamra N. Future perspective of probiotics in dermatology: an old wine in new bottle. Dermatology online journal. 2014;20(9).
4. Sebastian Domingo JJ. Review of the role of probiotics in gastrointestinal diseases in adults. Gastroenterologia y hepatologia. 2017;40(6):417-29.