Efficacy of Punica Granatum (Pomegranate) in the management of oral candidiasis – A randomized controlled study

Background: Oral candidiasis is an opportunistic fungal infection of the mucus membrane, where Candida albicans (C. albicans) is commonly responsible for the infection, especially in immune-compromised patients. Resistance of Candida species to antifungal drugs has led clinicians to pay more attention to alternative therapy. Punicalagin, isolated from pomegranate peel, was reported to be effective against C. albicans. This study compares the efficacy of Punica granatum peel extract gel 0.2% with topical clotrimazole in oral candidiasis. Materials and Methods: Forty-four oral candidiasis patients aged 20–67 years of either sex were enrolled. The swab samples from the oral lesion were collected for periodic acid Schiff (PAS) staining, and a quantitative analysis of Candida species was carried out. They were randomly divided into two groups. Group I subjects were administered a topical application of P. granatum gel 0.2%. Group II subjects were administered clotrimazole 1%. Both medicaments were administered in the form of a topical gel thrice a day for 14 days. Follow-up was done on the 7th and 14th days. Results: Reduction in burning sensation measured with the mean visual analog scale (VAS) score was from 2.0238 to 1.3095 in group I and from 1.4783 to 0.8913 in group II. Reduction in the lesion size from baseline to post-treatment was from 1.652 to 0.781 in group I and from 0.939 to 0.439 in group II. Also, a reduction in candidal colony count from baseline to post-treatment was observed in both groups. The taste and tolerability of punicalagin were acceptable. Conclusion: P. granatum 0.2% is safe, well tolerated, and effective for oral candidiasis.