Abstract: SA-PO1123
Oral Candidiasis in Kidney Transplant Recipients with and Without Nystatin Prophylaxis
Session Information
- Transplantation: Clinical - Infectious Diseases
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2002 Transplantation: Clinical
Authors
- Mahmoud, Saad Abdulrahim Talal, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States
- Alkhatib, Lean, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States
- Bhusal, Sushma, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States
Background
Oral candidiasis is a recognized complication following kidney transplantation, particularly during the early post-transplant period. Although nystatin is commonly used for antifungal prophylaxis, there is limited evidence supporting its routine use in kidney transplant recipients. At our center, we conducted a study to assess the effectiveness of nystatin prophylaxis by comparing the incidence of oral candidiasis in groups that received nystatin versus those that did not. This study took place after the discontinuation of nystatin at our institute on April 18, 2024, due to a nationwide shortage.
Methods
A retrospective cohort study at the University of Arkansas for Medical Sciences (UAMS) evaluated adult kidney transplant recipients from August 2023 to November 2025. Patients were divided into two groups: those who received 10 days of prophylactic nystatin (August 2023 - April 2024) and those who did not (April 2024 - November 2025). Excluded from the study were patients receiving other antifungal agents or those undergoing non-kidney transplants. The primary outcome measured was the development of oral candidiasis post-transplant.
Results
A total of 357 kidney transplant recipients were screened for oral candidiasis. Among those without prophylactic nystatin, 3.92% (10 out of 255) developed the infection, while 5.88% (6 out of 102) of those receiving nystatin were affected. This difference was not statistically significant (Fisher’s exact test, p = 0.407), with a risk difference of 1.96% (95% CI: -3.2% to 7.1%).
Conclusion
In this study, routine nystatin prophylaxis was not associated with a reduction in oral candidiasis among kidney transplant recipients over a follow-up period of 6 months to 3 years. These findings suggest a need to reconsider the routine use of nystatin prophylaxis after kidney transplantation.