Abstract
Our previous survey on off-label drug use in oral therapeutics and pharmacology, showed that amphotericin B syrup had been used to treat adult oral candidiasis in many hospitals. Based on the results, we studied how antifungal drugs were used for oral candidiasis in university dental hospitals, and searched for evidence of appropriate use of amphotericin B syrup for the treatment.
According to a questionnaire we conducted at 18 private dental college and university hospitals, miconazol gel and amphotericin B syrup were used in 15 and 13 hospitals, respectively. However, amphotericin B syrup occupied 2/3 of the total amount of anti-fungal drugs used in the 18 hospitals. Two different administration methods were observed: one method in which the preparation was swished in the mouth and then swallowed (in 4 hospitals), and the other in which it was gargled (in 9 hospitals) . Evidence of appropriate dosage and administration for both methods was searched in a computer database of Igakuchuoh Zasshi-CD-ROM, but there was only one literature about the gargle. There was another literature about swishing in the mouth, offered by the manufacturer. These two literatures were case reports and were considered to correspond with level III in AHCPR grading scale. Then we searched in PDR for higher evidence, and found a description that 1 mL of amphotericin B syrup was dropped onto the tongue and swished in the mouth before swallowing.
