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Preventive effects of topical washing with miconazole nitrate-containing soap to diaper candidiasis in hospitalized elderly patients: A prospective, double-blind, placebo-controlled study.
J Dermatol. 2017 Jul; 44(7):760-766.JD

Abstract

The objective of the present randomized, double-blind trial was to evaluate the efficacy and safety of daily washing with miconazole nitrate-containing soap for candidiasis at diaper-covered sites in elderly subjects under long-term inpatient care. To confirm the onset and disappearance of candidiasis, we microscopically evaluated the existence of the pseudohyphae and/or blastoconidia of Candida spp. We enrolled 75 elderly patients who wore diapers all day in the hospital or nursing home. Patients were randomly assigned to receive treatment with either miconazole soap or miconazole-free placebo soap, and 28 patients in the miconazole group and 27 patients in the placebo group were followed for 4 weeks. Although washing with miconazole soap did not affect the frequency of pseudohyphae/blastoconidia-positive patients, it significantly inhibited the positive conversion of pseudohyphae/blastoconidia compared with the placebo group. As a result, the frequency of patients positive for pseudohyphae/blastoconidia was significantly lower in the miconazole group than in the control group at 4 weeks (17.9% vs 44.4%). Clinically apparent diaper candidiasis did not develop in either group. Washing with miconazole soap was a significant independent factor for reducing the cases positive for pseudohyphae/blastoconidia, while diarrhea and heart failure were significant factors associated with an increase in the positive rate at the end-point. Severe adverse effects were not found in any patients. Thus, washing with miconazole soap is well-tolerated and can inhibit the positive conversion of Candida in patients wearing diapers. Therefore, maintenance of genital hygiene using this soap may prophylactically decrease the overall prevalence of patients with diaper candidiasis.

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Authors+Show Affiliations

Takahashi H
Department of Dermatology, Division of Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan. Department of Dermatology, JCHO Fukui Katsuyama General Hospital, Fukui, Japan.
Oyama N
Department of Dermatology, Division of Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.
Tanaka I
Department of Nursing, JCHO Fukui Katsuyama General Hospital, Fukui, Japan.
Hasegawa M
Department of Nursing, JCHO Fukui Katsuyama General Hospital, Fukui, Japan.
Hirano K
Department of Clinical Examination, JCHO Fukui Katsuyama General Hospital, Fukui, Japan.
Shimada C
Department of Clinical Examination, JCHO Fukui Katsuyama General Hospital, Fukui, Japan.
Hasegawa M
Department of Dermatology, Division of Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.

MeSH

AgedAged, 80 and overAntifungal AgentsCandidaCandidiasis, CutaneousDiaper RashDouble-Blind MethodFemaleGenitaliaHumansHygieneHyphaeJapanMaleMiconazoleMicroscopyPrevalenceProspective StudiesSkinSoapsSpores, FungalTreatment Outcome

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

28225185

Citation

Takahashi, Hidenori, et al. "Preventive Effects of Topical Washing With Miconazole Nitrate-containing Soap to Diaper Candidiasis in Hospitalized Elderly Patients: a Prospective, Double-blind, Placebo-controlled Study." The Journal of Dermatology, vol. 44, no. 7, 2017, pp. 760-766.
Takahashi H, Oyama N, Tanaka I, et al. Preventive effects of topical washing with miconazole nitrate-containing soap to diaper candidiasis in hospitalized elderly patients: A prospective, double-blind, placebo-controlled study. J Dermatol. 2017;44(7):760-766.
Takahashi, H., Oyama, N., Tanaka, I., Hasegawa, M., Hirano, K., Shimada, C., & Hasegawa, M. (2017). Preventive effects of topical washing with miconazole nitrate-containing soap to diaper candidiasis in hospitalized elderly patients: A prospective, double-blind, placebo-controlled study. The Journal of Dermatology, 44(7), 760-766. https://doi.org/10.1111/1346-8138.13781
Takahashi H, et al. Preventive Effects of Topical Washing With Miconazole Nitrate-containing Soap to Diaper Candidiasis in Hospitalized Elderly Patients: a Prospective, Double-blind, Placebo-controlled Study. J Dermatol. 2017;44(7):760-766. PubMed PMID: 28225185.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Preventive effects of topical washing with miconazole nitrate-containing soap to diaper candidiasis in hospitalized elderly patients: A prospective, double-blind, placebo-controlled study. AU - Takahashi,Hidenori, AU - Oyama,Noritaka, AU - Tanaka,Izumi, AU - Hasegawa,Michiko, AU - Hirano,Kaori, AU - Shimada,Chieko, AU - Hasegawa,Minoru, Y1 - 2017/02/22/ PY - 2016/09/29/received PY - 2016/12/24/accepted PY - 2017/2/23/pubmed PY - 2018/4/10/medline PY - 2017/2/23/entrez KW - diaper dermatitis KW - miconazole nitrate KW - microscopic examination KW - randomized controlled trial KW - washing soap SP - 760 EP - 766 JF - The Journal of dermatology JO - J Dermatol VL - 44 IS - 7 N2 - The objective of the present randomized, double-blind trial was to evaluate the efficacy and safety of daily washing with miconazole nitrate-containing soap for candidiasis at diaper-covered sites in elderly subjects under long-term inpatient care. To confirm the onset and disappearance of candidiasis, we microscopically evaluated the existence of the pseudohyphae and/or blastoconidia of Candida spp. We enrolled 75 elderly patients who wore diapers all day in the hospital or nursing home. Patients were randomly assigned to receive treatment with either miconazole soap or miconazole-free placebo soap, and 28 patients in the miconazole group and 27 patients in the placebo group were followed for 4 weeks. Although washing with miconazole soap did not affect the frequency of pseudohyphae/blastoconidia-positive patients, it significantly inhibited the positive conversion of pseudohyphae/blastoconidia compared with the placebo group. As a result, the frequency of patients positive for pseudohyphae/blastoconidia was significantly lower in the miconazole group than in the control group at 4 weeks (17.9% vs 44.4%). Clinically apparent diaper candidiasis did not develop in either group. Washing with miconazole soap was a significant independent factor for reducing the cases positive for pseudohyphae/blastoconidia, while diarrhea and heart failure were significant factors associated with an increase in the positive rate at the end-point. Severe adverse effects were not found in any patients. Thus, washing with miconazole soap is well-tolerated and can inhibit the positive conversion of Candida in patients wearing diapers. Therefore, maintenance of genital hygiene using this soap may prophylactically decrease the overall prevalence of patients with diaper candidiasis. SN - 1346-8138 UR - https://www.unboundmedicine.com/medline/citation/28225185/Preventive_effects_of_topical_washing_with_miconazole_nitrate_containing_soap_to_diaper_candidiasis_in_hospitalized_elderly_patients:_A_prospective_double_blind_placebo_controlled_study_ L2 - https://doi.org/10.1111/1346-8138.13781 DB - PRIME DP - Unbound Medicine ER -