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Thursday, 06 November 2014 18:27

Treatment for Pediatric Oral Candidiasis in Third-World Countries

1st Annual PCCA Poster Competition, Compounding Innovation at the International Seminar, Houston, USA (3 – 6 October 2014), Poster Presentation Finalist

By Alexandra Kerrigan, PharmD Candidate and Ron Hartman, PharmD, RPh, of NuCara Compounding Pharmacy, Ottumwa, Iowa


Oral candidiasis is easily treatable in most countries, but can be life-threating in third world countries. The purpose of this project was to find a suitable treatment option for oral candidiasis in pediatric patients in Tanzania. The project was researched from May to November 2013.


Outreach is an organization that uses many valuable resources to provide food, water, education, and medical care to those in need. Outreach and NuCara Pharmacy came together in hopes to bring better medical care to Tanzania. The project discussed here is the compounding of Nystatin lollipops. We utilized many resources to research Nystatin lollipops including PCCA, NuCara Research Group, and literature searches. This project was further complicated by the need for the final product to be inexpensive, have good stability, easy to transport, palatable, and relatively easy to compound in different strengths. The standard dose for pediatrics is 500,000 units. For our initial studies, we compounded Nystatin 500,000 U lollipops in a sorbitol base.


The lollipops were able to be compounded achieving our initial goals. Outreach staff shared that their most challenging cases were in infants, a patient population where lollipops would not be an acceptable dosage form. This added another dimension to this project—a final product that would meet the previous objectives while also being easily solubilized. With some experimentation we determined the prepared lollipops would easily dissolve in a minimal amount of water. This is key, as availability of potable water can be problematic. Samples were taken to Tanzania in October, 2013 and shared with hospital staff.


Nystatin lollipops for the treatment of oral candidiasis looks to be a great option. The convenience and cost-effectiveness of this compound is vital where treatment for oral candidiasis is too expensive or not available for all or a majority of the population. More research is needed to see if this compound is a viable option in very humid and hot third-world climates.