What are the symptoms of a yeast infection? Which antibiotics can cause yeast infections? How can you prevent a yeast infection from antibiotics?.

Understanding Yeast Infections

Vaginal yeast infections, also known as vaginal candidiasis, are caused by an overgrowth of a fungus called Candida albicans. This fungus naturally lives in warm, moist areas of the body, such as the mouth and around the genitals. When there is an imbalance, leading to an overgrowth of this fungus, an infection occurs.

Approximately 75% of people with vaginas will experience a vaginal yeast infection at some point in their lifetime. Around 1.4 million outpatient visits for vaginal candidiasis occur annually in the U.S. If you are experiencing symptoms, you should not feel any shame.

The Link Between Antibiotics and Yeast Infections

Antibiotics prescribed to kill bacteria and fight infection can also kill healthy bacteria in the process. This creates an imbalance in your body, which can sometimes make you more susceptible to an overgrowth of Candida albicans fungus.

The predominant group of bacteria that naturally occurs in a healthy vagina is Lactobacillus. These bacteria help protect against infection- and disease-causing agents by producing antimicrobial substances. When certain antibiotics are taken, these Lactobacillus bacteria can be killed or have their growth stalled.

Without enough Lactobacillus, your vagina becomes less acidic, creating a more favorable environment for yeast to grow.

Symptoms of a Yeast Infection

If you think you are suffering from a vaginal yeast infection, you may experience the following symptoms:

• Vaginal itching, irritation, or soreness
• Redness, itching, or swelling of the vulva
• Thick, white, cottage cheese-like vaginal discharge
• Increased vaginal discharge
• Pain during sexual intercourse
• Pain or discomfort when urinating

Mild yeast infections may go away on their own after a few days, but in most cases, they will get progressively worse if left untreated. In severe cases, you may experience redness, intense swelling, and cracks in the wall of the vagina.

Antibiotics That Can Cause Yeast Infections

Not all antibiotics will cause yeast infections, but certain medications can leave you more susceptible to vaginal candidiasis. Some of the antibiotics that can contribute to yeast infections include:

Amoxicillin

Amoxicillin is a penicillin-like antibiotic used for the treatment of ear infections, dental infections, pneumonia, and other bacterial infections.

Carbapenems

Carbapenems, such as meropenem and ertapenem, are broad-spectrum antibiotics used to treat serious bacterial infections. These medicines are often administered via IV and may be prescribed for urinary infections that are resistant to other antibiotics, bacterial meningitis, intra-abdominal infection, antibiotic-resistant pneumonia, cystic fibrosis, or febrile neutropenia.

Tetracyclines

Tetracyclines are commonly prescribed for the treatment of acne, eye infections, sexually transmitted infections, and skin infections. They can also be prescribed for infections that are spread by ticks. Some common brand names for tetracyclines include Doxycycline, Demeclocycline, Minocycline, Omadacycline, Tetracycline, and Eravacycline.

Quinolones

Quinolones are broad-spectrum antibiotics that are usually prescribed for difficult-to-treat UTIs, pneumonia, bronchitis, and bacterial prostatitis. Some common quinolones include Moxifloxacin, Ciprofloxacin, and Levofloxacin.

Preventing Yeast Infections from Antibiotics

There are several steps you can take to help prevent a yeast infection from occurring while taking antibiotics:

Fluconazole (Diflucan)

This is an oral prescription medication you can take to treat and prevent fungal infections. It is not advised for pregnant women.

Antifungal Medications

Over-the-counter antifungal creams or suppositories can help ward off yeast infections caused by antibiotics. For best results, follow the directions on the box and begin using your antifungal treatment simultaneously with the beginning of your antibiotic treatment.

Probiotics

Probiotics are living microbes sometimes called “good bacteria.” They are available through foods with live cultures, such as yogurt, and in supplements. Recent research suggests that taking probiotics can promote vaginal health.

Cotton Underwear

Wearing cotton underwear can help reduce your chances of getting a yeast infection. Yeast thrives in moist environments, and cotton absorbs moisture, making the environment less hospitable for the fungus.

Who is at Risk for Yeast Infections?

Certain factors can increase your risk of developing a yeast infection, including:

• Pregnancy
• Diabetes
• Weakened immune system
• Hormonal changes, such as those that occur with menstrual cycles or birth control pill use
• Douching or using scented feminine products
• Tight or restrictive clothing

If you are experiencing symptoms of a yeast infection, it is important to speak with your healthcare provider to determine the best treatment option for your specific situation.

Yeast Infection After Antibiotics: What To Know

Vaginal yeast infections (also known as vaginal candidiasis) are caused by a fungus called candida albicans.

This fungus lives in warm, moist parts of the body, such as the mouth and around the genitals.

When there is an overgrowth of this fungus, an infection occurs.

An estimated 75% of people with vaginas will experience a vaginal yeast infection in their lifetime.

Approximately 1.4 million outpatient visits for vaginal candidiasis occur annually in the U.S. So if you are experiencing an itch or burn down there, you shouldn’t feel any shame.

In this article, I’ll explore the link between yeast infections and antibiotics, the symptoms of a yeast infection, and antibiotics that can cause these infections.

I’ll also talk about how you can prevent these infections, and who is at higher risk for contracting one.

Finally, I’ll tell you when you should see a doctor or other healthcare provider about your symptoms.

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Antibiotics that are prescribed to kill bacteria and fight infection can also kill healthy bacteria in the process.

This creates an imbalance in your body, which can sometimes make you more susceptible to an overgrowth of candida albicans fungus. 

The predominant group of bacteria that naturally occurs in a healthy vagina is Lactobacillus.

These bacteria help protect against infection- and disease-causing agents by producing antimicrobial substances.

These bacteria can be killed—or have their growth stalled—when certain antibiotics are taken.

When your body does not have enough Lactobacillus, your vagina becomes less acidic.

This creates a more favorable environment for yeast to grow.

Symptoms of a Yeast Infection

If you think you are suffering from a vaginal yeast infection, you may experience the following symptoms:

• Vaginal itching, irritation, or soreness
• Redness, itching, or swelling of the vulva
• Thick, white, cottage cheese-like vaginal discharge
• Increased vaginal discharge
• Pain during sexual intercourse
• Pain or discomfort when urinating

Mild yeast infections will go away on their own after a few days.

But in most cases, they will get progressively worse if left untreated.

In severe cases, you may experience redness, intense swelling, and cracks in the wall of the vagina.

Speak with your healthcare provider to find the best treatment option for you.

Which Antibiotics Cause Yeast Infections?

Not all antibiotics will cause yeast infections, but certain medications can leave you more susceptible to vaginal candidiasis. 

Amoxicillin

Amoxicillin is a penicillin-like antibiotic used for the treatment of ear infections, dental infections, pneumonia, and other bacterial infections. 

Carbapenems

Carbapenems, such as meropenem and ertapenem, are broad-spectrum antibiotics used to treat serious bacterial infections.

These medicines are often administered via IV.

You may be prescribed carbapenems if you have urinary infections that are resistant to other antibiotics, bacterial meningitis, intra-abdominal infection, antibiotic-resistant pneumonia, cystic fibrosis, or febrile neutropenia.

Tetracyclines

Tetracyclines are commonly prescribed for the treatment of acne, eye infections, sexually transmitted infections, and skin infections.

They can also be prescribed for infections that are spread by ticks.

Some common brand names for tetracyclines include:

• Doxycycline (Adoxa)
• Demeclocycline (Declomycin)
• Minocycline (Minocin)
• Omadacycline (Nuzyra)
• Tetracycline (Sumycin)
• Eravacycline (Xerava)

Quinolones

Quinolones are broad-spectrum antibiotics that are usually prescribed for difficult-to-treat UTIs, pneumonia, bronchitis, and bacterial prostatitis.

Some common quinolones include:

• Moxifloxacin (Avelox)
• Ciprofloxacin (Cipro)
• Levofloxacin (Levaquin)

How to Prevent a Yeast Infection from Antibiotics

Fluconazole (Diflucan)

This is an oral prescription medication you can take to treat and prevent fungal infections.

It is not advised for pregnant women. 

Antifungal medications

An over-the-counter antifungal cream or suppository can help ward off yeast infections caused by antibiotics.

For best results, follow the directions on the box, and begin using your antifungal treatment simultaneously with the beginning of your antibiotic treatment. 

Probiotics

Probiotics are living microbes sometimes called “good bacteria.”

They are available through foods with live cultures, such as yogurt, and in supplements.

Recent research suggests that taking probiotics can promote vaginal health. 

Cotton underwear

Wearing cotton underwear can help reduce your chances of getting a yeast infection.

Yeast thrives in moist environments.

Cotton absorbs moisture, making the environment less hospitable for the fungus. 

Who is at Higher Risk of Developing a Yeast Infection?

Any woman at any age can get a yeast infection and most will experience at least one in their lifetime, but it is more than likely to occur in women after puberty and before menopause.

Another risk factor is having higher estrogen levels.

You may have higher estrogen levels if you are pregnant, taking high-dose estrogen birth control pills, or undergoing estrogen hormone therapy.

Diabetes or a weakened immune system can also put you at an increased risk for yeast infections. 

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When to See a Doctor or Healthcare Professional

If you are struggling with symptoms of itchiness, irritation, redness, burning, and cracks in the wall of your vagina, you should see a healthcare provider for a diagnosis and treatment plan.

If you develop a yeast infection while using an OTC antifungal vaginal cream or suppository in conjunction with your antibiotics, contact a healthcare provider.

They will be able to examine you and determine the best medication for you.

They may take a small sample of vaginal discharge to test under a microscope to form their diagnosis.

How K Health Can Help

Did you know that you can get yeast infection treatment online through K Health?

We have clinicians available 24/7 to get you the care or medication that you need.

Frequently Asked Questions

Is it common to get a yeast infection after taking antibiotics?

Yes. Many antibiotics kill the healthy bacteria that keep yeast under control. This can lead to an overgrowth of the yeast—an infection.

How do you treat a yeast infection after antibiotics?

Using an over-the-counter or prescription antifungal treatment should work for all yeast infections, including those caused by antibiotics.

How long after antibiotics will yeast infection go away?

With an antifungal medication, yeast infection symptoms should begin to lessen in 3-7 days. Without treatment, most yeast infections do not get better on their own.

Can you get a yeast infection 2 weeks after antibiotics?

Yes. Since antibiotics are used to kill off harmful bacteria in the body, they can also destroy healthy bacteria in the process. This can lead to a vaginal yeast infection that may occur during your course of antibiotics, or for a period of weeks afterward while there is still an imbalance of beneficial bacteria.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

K Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions,
and medical associations. We avoid using tertiary references.

• Does probiotics work for bacterial vaginosis and vulvovaginal candidiasis. (2021).
  https://www.sciencedirect.com/science/article/pii/S1471489221001442?via%3Dihub

• Warding Off Recurrent Yeast and Bacterial Vaginal Infections: Lactoferrin and Lactobacilli. (2020).
  https://www.ncbi.nlm.nih. gov/pmc/articles/PMC7023241/

• The Role of Fatty Acid Metabolites in Vaginal Health and Disease: Application to Candidiasis. (2021).
  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8282898/

• Quinolones and the Clinical Laboratory. (2019).
  https://www.cdc.gov/hai/settings/lab/quinolones-clinical-laboratory.html

• Carbapenem antibiotics for serious infections. (2012).
  https://www.bmj.com/content/344/bmj.e3236

• Vaginal Candidiasis. (2021).
  https://www.cdc.gov/fungal/diseases/candidiasis/genital/index.html

• Study of Antibiotic-induced Vaginal Yeast Infections in Healthy Women. (2019).
  https://www.clinicaltrials.gov/ct2/show/NCT01915251

Yeast infection from antibiotics: Causes, symptoms, and treatment

Taking certain antibiotics may lead to a yeast infection in the vagina, also known as a fungal infection or vaginal candidiasis.

A yeast infection is a form of vaginitis, which means inflammation in the vagina. Vaginitis is the most common vaginal condition in people aged 15–44.

Vaginal candidiasis, caused by Candida fungus, is the second most common type of vaginal infection in the United States, after bacterial infections.

This article examines how taking antibiotics can sometimes lead to yeast infections. It also describes which antibiotics can cause these infections and how to treat them.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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A yeast infection occurs when something upsets the delicate balance of bacteria and yeast in the vagina.

A small amount of Candida fungus is usually present in the vagina, and beneficial bacteria help keep this fungus under control.

Antibiotics work by killing bacteria that cause infection, but they can also kill beneficial bacteria in other parts of the body, including the vagina.

Without enough beneficial bacteria to keep the yeast at bay, Candida yeast can multiply, causing the symptoms of a yeast infection.

Some people are more prone to yeast infections than others. According to current estimates, 8% of females have recurring Candida infections, and around 70% of females report dealing with this condition at least once in their lifetime.

Yeast infections can develop at any age, but these infections are more common during reproductive years.

The common symptoms of a vaginal yeast infection tend to be more noticeable just before menstruation. A person may experience:

• an itchy sensation on and around the vulva, which is the area outside the vagina
• a burning sensation on or around the vulva
• white, lumpy, odorless vaginal discharge
• pain during sex
• pain or discomfort while urinating
• an increase in vaginal discharge

These symptoms are mild in most cases. In severe infections, redness, swelling, or cracks form in the walls of the vagina.

It can be difficult to distinguish between a yeast infection and a urinary tract infection (UTI). Learn to tell the difference here.

Not all antibiotics are likely to cause yeast infections — only broad-spectrum antibiotics tend to have this effect. These drugs can kill several different types of bacteria.

The following three types of broad-spectrum antibiotic, in particular, may increase the risk of a yeast infection:

Tetracyclines

Doctors prescribe tetracyclines for acne, UTIs, intestinal tract infections, eye infections, sexually transmitted infections, and gum disease.

Examples of tetracyclines and common brand names include:

• demeclocycline (Detravis)
• doxycycline (Adoxa)
• eravacycline (Xerava)
• minocycline (Minocin)
• omadacycline (Nuzyra)
• tetracycline (Sumycin)

Quinolones

Doctors prescribe quinolones for difficult-to-treat UTIs, hospital-acquired pneumonia, and bacterial prostatitis. Common examples include:

• ciprofloxacin (Cipro)
• levofloxacin (Levaquin)
• moxifloxacin (Avelox)

Broad-spectrum penicillins

Broad-spectrum penicillins, such as ampicillin and amoxicillin, may also lead to yeast infections.

Yeast infections are common, but a few circumstances may make it more likely a person will develop one. These circumstances include:

• pregnancy
• hormone contraceptive use, such as birth control pills
• diabetes
• a weakened immune system due to factors such as chemotherapy treatment or HIV infection

If a person is living with one of these risk factors, they should talk with their doctor if they have been prescribed antibiotics, as there can be an increased risk of yeast infection.

While yeast infections are more common among sexually active people, there is no evidence that they are sexually transmitted.

Treating a yeast infection is usually a straightforward process. In most cases, a person will either apply a cream or ointment to the inside of the vagina or take a pill containing an antifungal medicine, such as fluconazole or miconazole.

A doctor can prescribe antifungal creams or tablets. People can also find over-the-counter (OTC) antifungal vaginal creams at drugstores, or online.

Some infections, such as recurring chronic infections, may require stronger treatment. In this case, a doctor may recommend additional doses of fluconazole or creams that contain boric acid, nystatin, or flucytosine.

The Centers for Disease Control and Prevention (CDC) recommend that anyone who suspects they have vaginal candidiasis speak with a healthcare professional. This is because the symptoms are similar to those of other vaginal infections, which require different treatments.

A healthcare professional can ensure that a person gets the right medication for the infection. To identify vaginal candidiasis, they usually take a small sample of vaginal discharge for examination under a microscope.

Pregnancy and fluconazole

Pregnant people may want to avoid treating yeast infections with fluconazole due to the risk of birth abnormalities. According to an older safety announcement from the Food and Drug Administration (FDA), a single 150-microgram dose of fluconazole may not cause this effect, but taking it for longer periods or at a higher dosage carries this risk.

While a 2013 study did not find a significantly increased risk of birth abnormalities when pregnant people took fluconazole, a more recent cohort study from 2020 did find an association with fluconazole use during the first trimester and musculoskeletal malformations.

Pregnant individuals managing a yeast infection should discuss with their doctor about the risks of fluconazole, and other alternative treatments.

People can help prevent vaginal candidiasis by taking antibiotics only when they are necessary. It is worth remembering that antibiotics do not work on viral infections, such as a cold or the flu.

Antibiotics also do not work on some common bacterial infections, such as many types of bronchitis, sinus infections, and ear infections. A person should always speak with a healthcare professional before starting a course of antibiotics.

A few other ways to help prevent yeast infections include:

• wearing cotton undergarments
• avoiding feminine hygiene sprays
• avoiding scented tampons
• avoiding harsh soaps when cleaning the vagina
• using condoms during sex

In addition, there is some evidence that eating yogurt that contains live cultures every day or taking Lactobacillus acidophilus capsules may help prevent these infections.

While little high quality research has investigated this use of probiotics, many healthcare professionals recommend taking a probiotic supplement either during or immediately after completing a course of antibiotics to reduce the risk of a yeast infection.

Some types of antibiotics can lead to a vaginal yeast infection, which is a form of vaginitis known as vaginal candidiasis.

Antibiotics kill bacteria, which can upset the delicate balance of yeast and bacteria in the vagina. This allows the Candida fungus to multiply, leading to symptoms such as itching, burning, or pain during sex.

It is usually straightforward to treat yeast infections with OTC antifungal medications. However, anyone who suspects that they have this type of infection should consult a doctor to rule out other issues with similar symptoms.

Etiology, treatment, prevention of candidiasis – Artiklid

Causes

Certain drugs can modify the microflora of the oral cavity, which may be a favorable factor for the growth of Candida. These include long-term use of antibiotics, steroid drugs, and high-estrogen oral contraceptives. Other factors that can encourage fungus growth include diabetes, pregnancy, iron supplementation, vitamin B12 and zinc deficiencies, and use of antihistamines.

Factors that weaken the immune system, from cancer chemotherapy to stress or depression, can also be a cause of candidiasis.

Treatment

Topical treatment (effective only at the site of application) is generally the primary treatment for oral candidiasis, and is usually effective for mild to moderate disease. Topical treatment for candidiasis usually includes tablets (lozenges) and mouth rinses. One or two tablets are taken three to five times a day, they must be dissolved in the mouth, without chewing or swallowing.

Usually clotrimazole or nystatin is used. Mouth rinses are usually less effective than tablets due to less contact time with the affected area. However, they are best used in patients with dry mouth. Rinsing is carried out between meals, in a certain dosage, the solution is kept in the mouth as long as possible. After rinsing, the solution is swallowed.

Gargle at least 4 times a day and continue for several days after the symptoms have disappeared (two weeks in total). The most commonly used for this procedure is nystatin. General treatment is used for recurrent candidiasis or in the acute stage, when local treatment is ineffective. Also, the general treatment is used for esophageal candidiasis. Three antifungal drugs have proven themselves well: ketoconazole (Nizoral), fluconazole (Diflucan), and itraconazole (Sporanox). Usually doctors start with less aggressive therapy (ketoconazole and itraconazole) and leave the stronger fluconazole for later use if needed. -V (Fungizon).

Fluconazole is used at a dose of 200 mg once a day. Treatment usually lasts 2 weeks for candidiasis of the oral mucosa, and three weeks for esophageal candidiasis (or two weeks after the symptoms disappear). Itraconazole is usually used at a dose of 100 mg once a day for oral candidiasis for one to two weeks, and 200 mg once a day for esophageal candidiasis for two to three weeks. The drug is taken with food. The use of itraconazole solution gives higher levels of the drug in the blood, and is more effective than taking capsules.

Ketoconazole (Nizoral) is usually taken at a dose of 200 mg once a day for one to two weeks for oral candidiasis, and at a dose of 400 mg once a day for esophageal candidiasis for two to three weeks. The drug is taken with food. The drug may be poorly absorbed in patients who have bowel problems and who cannot eat normally. This situation can be avoided if you take ketoconazole along with acidic drinks.

Amphotericin B is given as an oral solution (100 mg daily in 4 divided doses) or intravenous injection (5 mg/kg daily) for two to three weeks. There is a new liposomal formulation of amphotericin B-lipid complex (Abelcet) given as an intravenous injection at a dose of 5 mg/kg per day for two to three weeks.

Antifungals and pregnancy

Guidelines for the prevention of opportunistic infections include advice on the use of antifungals during pregnancy. The oral administration of azoles – fluconazole, itraconazole, ketoconazole, is not recommended, as this may affect the developing child. For the treatment and prevention of oral candidiasis, topical antifungal therapy such as nystatin is preferred in pregnant women. The use of amphotericin B is also justified for the treatment of oral candidiasis. Although no specific studies have been conducted, amphotericin B is used in pregnant women without harm to the unborn child. Although amphotericin B is preferred in the treatment of pregnant women, possible side effects, including renal intoxication and anemia, cannot be ignored.

Treating and preventing influenza naturally

There is a strong connection between what you eat and the health of your immune system. However, nutritional approaches to the prevention and treatment of diseases such as candidiasis are complex and controversial. There is no magic cure for preventing and treating yeast infections in every person, but some general guidelines can reduce the risk of a yeast infection becoming a problem. Most nutritionists agree that sugar, yeast, dairy products, flour products, caffeine, and alcohol are the main culprits in Candida disease because they promote fungal growth. Nutritionists recommend eating as little as possible of those foods that stimulate excess production of the fungus. Another approach is to increase the amount of food consumed that can suppress the development of the fungus. For example, garlic is considered a food with natural antifungal activity and may help prevent candidiasis. Fresh garlic is considered the best, but commercial preparations of garlic do not have a strong odor, which is an advantage. Garlic can be eaten raw, or crushed and placed in empty softgels, up to 6 garlic cloves per day. It is not known whether there is an interaction when taking large amounts of garlic and drugs used to treat AIDS, but it is noted that there may be an increased risk of side effects when taking ritonavir (Norvir). Another factor causing the uncontrolled growth of the fungus is the use of antibiotics. There are always friendly bacteria in the body, and they, despite the growth of the fungus, maintain a normal balance in the body. These are lactic acid bacteria, and most antibiotics (such as tetracyclines and penicillin) kill these bacteria, allowing the fungus to grow. In order to reduce these effects when taking antibiotics, nutritionists recommend adding lactic acid bacteria to the diet. To do this, you need to take yoghurts and natural dairy products, while the packaging should contain information about the presence of these bacteria.

Oral candidiasis can alter taste perception. Eating and swallowing may also be difficult. These phenomena can be reduced by avoiding acidic, spicy or hot foods, cigarettes, alcohol and carbonated drinks, as all of them can irritate the oral mucosa. It is recommended to take cold, soft food (oatmeal, applesauce, etc.).

Many people use liquid supplements to relieve the pain of mouth infections and to maintain or gain weight. Unfortunately, many of these supplements are high in sugar, which can promote Candida growth. If you are taking these supplements, make sure they are mostly complex carbohydrates, high in protein, and low to medium in sugar. It is important to remember that these products are purely supplements and should not replace main meals.

Gargling with tea tree oil diluted in water has been shown to help treat oral candidiasis. These rinses (2 drops of oil per tablespoon of water) are carried out in the morning, evening and after each meal. Sometimes this solution is applied directly to the affected area in the mouth (1 drop of oil to 1 drop of water). Grapefruit seed extract and 1% hydrogen peroxide can be used in the same way, but they must be diluted more strongly, and in no case should they be swallowed.

However, these treatments (especially the use of grapefruit seed extract) can irritate the oral mucosa and promote infection. Moreover, they are aimed only at eliminating local symptoms, but not the cause of the disease.

Positive effects of changing the diet on the course of fungal infection

• Limitation or complete elimination of sugars (syrups, fructose, glucose and sucrose). Sugars are a good breeding ground for candida and promote its growth.

• Restriction or elimination of alcohol. Alcohol is converted into sugar and thus promotes the growth of the fungus.

• Some nutritionists suggest that garlic has a natural antifungal effect. It is recommended to consume fresh garlic, up to 6 cloves per day for the prevention of candidiasis.

• The use of dairy products, yogurts, which contain lactic acid bacteria help to maintain the internal balance of the body and counteract foreign bacteria and fungi (like candida).

What they treat us with: Nystatin – Indicator

Medicine

14:37, 08 March 2019 part of the time the fungus was accused of a non-existent disease, how are we like mushrooms, why the fight against a fungal infection is both dangerous and difficult, and also what Nystatin helps with, and where its uselessness has been proven, Indicator.Ru tells.

The antifungal drug Nystatin is the 217th most commonly prescribed drug in the US. In 2018, it was prescribed 2,464,584 times to residents of this country. Nystatin is prescribed against diseases associated with fungal infections – most often candidiasis. This group of diseases includes not only the thrush famous for unpleasant advertising: fungi of the genus Candida (especially Candida albicans ) also causes diaper dermatitis in babies, affects the skin, and can infect the mouth, pharynx and esophagus.

Yeast Werewolves and a Nonexistent Disease

Fungi Candida is a yeast infection, so it is often referred to as a yeast infection. Of course, this is not the kind of yeast that you can find in the grocery store, because yeast refers to all single-celled fungi that do not form mycelium and live in a liquid or nutrient-rich environment. Anyway, genus Candida belongs to the group of “true yeasts” ( Saccharomycotina ) and is considered not only a “classmate” (according to the class Saccharomycetes ), but also a relative of the family ( Saccharomycetaceae ) of bakers, pubs and other thousand years of employees of the food industry yeast .

Candidiasis is an opportunistic infection. This means that most of the time, the werewolf fungus lives harmlessly on the surface of our skin and mucous membranes, along with a whole host of other microorganisms (you can learn more about its two-faced nature in this review). But sometimes diseases undermine the strength of our body or harmless bacteria – the “civilian population” of our skin – fall under distribution when we use antibiotics in the fight against real enemies. Sometimes immunity suffers due to type 2 diabetes, chemotherapy, suppression of HIV or doctors (so that the body does not reject transplanted organs). All these cases are the finest hour for Candida albicans : that’s when he shows his selfishness and seizes the moment, so in such situations, doctors prescribe antifungal drugs for prevention.

At one time, some researchers even tried to blame the two-faced fungus for all mortal sins, attributing to its influence (on hypersensitive people, which can be up to a third of the entire population) a bunch of vague symptoms – weight gain, chronic fatigue, joint and muscle pain, asthma and constipation. However, the scientific community rejects this idea (for example, in these papers 1, 2) and even calls its followers a “pseudo-scientific cult”. It was not possible to prove the existence of this influence – and, accordingly, it will not work to cure a non-existent ailment with Nystatin. There is even a double-blind controlled clinical trial on this score (although there are conflicting data). But we will return to research – let’s better see what Nystatin is.

From what, from what

The active component of the drug, known under the names Nystatin or Mykostatin, refers to polyenes – substances in the structure of which at least three double bonds between carbon molecules can be found. Nystatin, from which the drug of the same name is made, was isolated from the bacteria Streptomyces noursei in 1950 and was the first antifungal drug from this chemical group.

Like many antibiotics prescribed against fungi, Nystatin is more dangerous to humans than antibacterial drugs. Mushrooms, like protozoa, are much more like us: like us, they belong to eukaryotes, in whose cells there is a nucleus (and animals and fungi are also grouped into the posterior flagellar group, unlike, for example, plants). We have a similar structure of cells and mechanisms of protein synthesis. Therefore, finding a weak spot in a bacterium that a person does not have is much easier than finding it in a fungus.

Nystatin binds to ergosterol molecules, which make up the majority of the cell membrane of many fungi. So it prevents the cell from shutting itself off from the outside world and clearly regulating what substances will come from outside. Instead, cholesterol molecules can be found in the shell of animal cells. The fungus dies, but the problem remains: Nystatin is not very picky and can bind to other sterols, causing harm to human cells as well.

You can learn how to understand medicines on your own in the author’s online course “How they treat us” from the editor of Indicator. Ru Ekaterina Mishchenko: https://clck.ru/Pnmtk

Once inside the “cellular powerhouses” – mitochondria, it, according to a review in the scientific journal Applied Microbiology and Biotechnology, inhibits the work of the respiratory electron transport chain, which helps us extract energy from oxygen and food, and also interferes with an important family of enzymes – cytochromes P450 – break down and neutralize substances harmful to the body. Therefore, theoretically, such treatment can be quite toxic, although it should work against most fungal infections.

Nystatin vs microwave

Nearly four dozen double-blind controlled clinical trials have focused on Nystatin, which can be applied to the infected area or taken internally for fungal infections.

Double-blind, randomized, placebo-controlled method is a method of clinical drug research in which subjects are not privy to important details of the study being conducted. “Double-blind” means that neither the subjects nor the experimenters know who is being treated with what, “randomized” means that the distribution into groups is random, and placebo is used to show that the effect of the drug is not based on autosuggestion and that this medicine helps better than a tablet without active substance. This method prevents subjective distortion of the results. Sometimes the control group is given another drug with already proven efficacy, rather than a placebo, to show that the drug not only treats better than nothing, but also outperforms analogues.

Indicator.Ru

Help

Several articles talk about how Nystatin fights candidiasis or stomatitis due to wearing dentures. For example, one study compared a topical preparation with an aqueous extract of garlic in 40 patients, another with microwave disinfection of false teeth, and both treatments were as effective as Nystatin. Another work shows the effectiveness of Nystatin lozenges (24 patients in total). A review of studies on the treatment of oral and pharyngeal candidiasis concludes that Nystatin is superior to placebo but inferior to another antifungal agent, fluconazole.

Other work concerns diaper dermatitis – for example, a study published in The Journal of Pediatric in 1982 shows that the use of nystatin both internally and topically will be equally effective as only topical, and each of them requires more than 10 days (but both methods are superior to placebo).

What do the Cochrane reviews tell us? Eight of them are dedicated to Nystatin.

The Cochrane Library is a database of the Cochrane Collaboration, an international non-profit organization involved in the development of World Health Organization guidelines. The name of the organization comes from the name of its founder, the 20th-century Scottish medical scientist Archibald Cochrane, who championed the need for evidence-based medicine and the conduct of competent clinical trials and wrote the book Efficiency and Efficiency: Random Reflections on Public Health. Medical scientists and pharmacists consider the Cochrane Database one of the most authoritative sources of such information: the publications included in it have been selected according to the standards of evidence-based medicine and report the results of randomized, double-blind, placebo-controlled clinical trials.

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Tests on 4226 patients, summarized in a review that looked at the ability of antifungal drugs to prevent oral candidiasis during chemotherapy, provided strong evidence that drugs that are absorbed in the gastrointestinal tract do their job, but Nystatin (which is not absorbed) does the worst. The effectiveness of Nystatin for the prevention of oral candidiasis in children and adults with HIV has not been established. In general, in immunosuppressed patients, the authors of another review (this time based on 14 studies of 1569patients) do not recommend Nystatin: it has been proven that it is useless for prevention.

Pregnancy, neonatal and dialysis

For vaginal candidiasis in pregnant women, Nystatin creams and ointments have been shown to be effective. However, drugs from the imidazole group worked better than him. True, the standard course of four days was insufficient for most patients, but the seven-day course made it possible to cure 90% of the participants.

In very low birth weight infants, nystatin may help prevent fungal infections, although it does not reduce the risk of death. However, the review authors recommend that these results be treated with caution, as the quality of research on this topic is questionable. Evidence that Nystatin helps in the prevention of fungal infections in children and adults in severe conditions, but with a normal level of neutrophils (a type of immune cell – white blood cells) in the blood, is also considered weak. But although the issue of suppressing infections remains open, it is known that the growth of fungi in the body (excluding blood), even when they are not yet pathogenic, such drugs suppress.

Finally, another review looks at the effectiveness of antifungal drugs in peritoneal or peritoneal dialysis, where a serous membrane called the peritoneum is used as a membrane to filter fluids and exchange them with the blood. This procedure is needed for people whose kidneys have failed, but because of it, an infection can be introduced into the peritoneum, causing peritonitis. Fluconazole and Nystatin taken by mouth have been reported (39 studies in 4435 patients) to help prevent fungal infections.

Indicator.Ru recommends: better placebo, but weaker than imidazoles

Nystatin is a veteran in the war against werewolf fungi. Not surprisingly, the drug is included in the list of the most important, cheap and effective drugs according to the World Health Organization. Despite the fact that fungi are becoming resistant, and new drugs (Fluconazole and other imidazoles) are stronger in action, Nystatin still remains effective against fungal infections when wearing dentures and diapers. For prevention, however, it is not always useful: for patients with HIV, immunosuppressed patients and during chemotherapy, it most likely will not help. However, with peritoneal dialysis, nystatin prevents fungal peritonitis.

Nystatin should not be stopped early, even if there is improvement, otherwise the fungus can grow with renewed vigor (for example, with vaginal candidiasis in pregnant women, the drug helps in seven days rather than four, and with oral candidiasis, it may require three weeks of treatment ). However, this rule has an exception.

Hypersensitivity to the components of the drug can cause contact dermatitis in 0.1% of patients. Even rarer, but much more dangerous, may be another variant of an allergy to Nystatin. If you have a fever and flu-like joint pain due to the use of the medicine, painful wet areas appear on the skin, the mucous membranes become blistered, and the eyes itch and hurt, it is better to stop taking the drug and consult a doctor. The described symptoms are harbingers of serious damage to the skin and mucous membranes associated with the death of dermal cells. This condition is called Stevens-Johnson syndrome, and if the cause of such a reaction is not removed (usually a drug), it threatens to develop into toxic epidermal necrosis, causing pneumonia, blood poisoning (sepsis), and even multiple organ failure. All of these conditions can quickly lead to death.

Although these cases are very rare, antibiotics that target fungi are more harmful to humans than antibiotics that target bacteria. Therefore, before treatment, you should make sure that you are infected with a fungus, and not bacteria, so as not to create additional difficulties for your body.

But, according to the review in Applied Microbiology and Biotechnology mentioned at the beginning of the article, the development of antifungal drugs is moving slowly. First, because mushrooms are relatively similar to us, and they are difficult to exterminate without harming yourself.