PP-027 Preparation of topical amphotericin for oropharyngeal candidiasis in pregnant women

BackgroundOropharyngeal candidiasis is a common local infection usually caused by candida species. The primary treatment is usually nystatin or topical azoles but both drugs are known to be teratogenic, at least during first semester of pregnancy.PurposeThe aim was to present a new buccal formulation of amphotericin and determine its effectiveness in the treatment of oropharyngeal candidiasis in pregnant women.Material and methodsA bibliographic research was conducted to find the appropriate active substance that could be used during pregnancy and, as a result, amphotericin was chosen as it is considered the safest antifungal (it is classified in the B group of the FDA list) compared with other antifungal agents. Regarding excipients, we searched on Martindale, European Pharmacopoeia, etc, to find ones suitable that were compatible with the oropharyngeal mucosae.ResultsThe formulation was prepared from the amphotericin in powder form and dissolved in propylenglycol, Tween 80 and finally water. Strawberry extract was added. This topical solution had an amphotericin concentration of 25 mg/mL. The patient showed an improvement during treatment with amphotericin mouthwash, mentioning that the ulcers and little haemorrhages started to decrease after 3 days and that all symptoms remitted after 8 days. No relapses have occurred. The formulation was tolerated well without any adverse effects.ConclusionAmphotericin formulated as a mouthwash is an attractive alternative for oropharyngeal candidiasis in pregnant women.No conflict of interest