Probiotics as a Complementary Approach in Managing Oral Candidiasis: Evidence from a Controlled Trial

Background: Oral candidiasis is a common fungal infection, particularly in immunocompromised individuals.Despite the effectiveness of antifungal treatments, recurrence rates, and treatment resistance remain challenges.Probiotics have shown potential as a complementary therapy, but evidence from randomized controlled trials is limited.This study aimed to evaluate the efficacy of probiotics in managing oral candidiasis.Materials and methods: A randomized controlled trial was conducted with 100 participants diagnosed with oral candidiasis, divided into a probiotic group (n = 50) and a control group (n = 50).Participants in the probiotic group received probiotics alongside standard antifungal treatment, while the control group received only antifungal treatment.The primary outcomes were the reduction in Candida colony-forming units (CFUs) and clinical improvement using the oral candidiasis severity index (OCSI).Secondary outcomes included patient-reported pain and discomfort measured by VAS scores.Data were collected at baseline, day 7, and day 14.Results: Out of 100 participants, 75 completed the study.At baseline, both groups had comparable Candida CFU counts and OCSI scores.By day 14, the probiotic group showed a significantly greater reduction in CFU counts (300 vs 600, p = 0.001) and OCSI scores (1.2 vs 2.8, p = 0.0001) compared to the control group.The probiotic group also reported significantly lower pain and discomfort by day 14 (VAS score: 1.5 vs 3.1, p = 0.0001).Adverse events were minimal and included mild gastrointestinal discomfort in the probiotic group.Conclusion: Probiotics, when used as an adjunct to antifungal therapy, significantly reduce Candida colonization and improve clinical outcomes in oral candidiasis.Probiotics were well tolerated and provided a promising complementary treatment option for managing this condition.Further studies are recommended to explore long-term benefits and recurrence prevention.