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Reviving the interest in the versatile drug nystatin: A multitude of strategies to increase its potential as an effective and safe antifungal agent

Nystatin reveals outstanding potential as an antifungal drug due to its broad-spectrum antifungal action against candidiasis, cryptococcosis, aspergillosis, and histoplasmosis, neglected diseases now regarded as a priority for the WHO. It still belongs to the main prescribed treatments for oral candidiasis, thanks to its high efficacy, low cost, and few adverse effects. On the other hand, it is a puzzling molecule to work with and its unstable physical and chemical behavior complicates its analysis, stabilization, and quantification in pharmaceutical samples and, therefore, limits its application in therapeutics. Despite its incredible versatility, nystatin’s use has been restricted to oral…

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  Nystatin Dose for Infants

Give 1 ml of nystatin 4 times a day after meals or at least 30 minutes before you feed your baby. Place the nystatin in the front of the mouth on each side. It doesn't do any good once it's swallowed. If the patches of thrush in the mouth don't start improving in 2 days, rub the nystatin directly on the patches. Use a cotton swab or a gauze wrapped on your finger. Keep this up for at least 7 days, or until all the thrush has been gone for 3 days.

 Elizabeth Lee Hazen and Rachel Fuller Brown

Nystatin, which is now known by a number of brand names, including Mycostatin, has been used for years as an effective treatment for fungal infections of the skin, mouth, vagina, and intestinal tract. The discovery of nystatin by Elizabeth Lee Hazen (1885–1975) and Rachel Fuller Brown (1898–1980) at the Division of Laboratories and Research of the New York State Department of Health (“the Division”) was inspired by the discovery and development of penicillin (see Alexander Fleming and Howard Florey and Ernst Chain) and by the success of biochemist and microbiologist Selman Waksman in screening soil samples for antibacterial agents.

Articles of Interest

Nystatin Effectiveness in Oral Candidiasis Treatment: A Systematic Review & Meta-Analysis of Clinical Trials

Antifungal therapies have evolved over time. Nowadays, newer triazoles and echinocandins have high range of antifungal activity with better patient acceptance in terms of ease of dosage and better tolerability, especially in recurrent/recalcitrant cases. Yet, topical therapy using nystatin is still the mainstay for the treatment of oral candidiasis, because of its increased efficacy, low cost, and less side effects. Photodynamic therapy is an expensive option, though it is quite efficacious. Therefore, nystatin suspensions can be the treatment regimen of choice for denture stomatitis, as the present descriptive analysis highlights the equal efficacy of 100,000 IU of nystatin suspension and six sessions of PDT.

The Persistence of Nystatin Use for Dermatophyte Infections

Topical nystatin is limited in its use for the treatment of tinea infections, especially because of its relatively poor minimal inhibitory concentration and minimal fungicidal concentration compared to other topical antifungals. As there are more effective alternatives, any continued use of this medication is an area for quality improvement.

Why Is Oral Thrush So Common in Babies?

Babies aren’t born with a fully developed immune system — it actually takes several months for it to develop. Since their immune system isn’t fully developed, Candida can grow unchecked. If your baby has thrush, it does not mean there is anything wrong with their immune system. Oral thrush is very common in babies.

Resources

BuzzRX

Is nystatin an antibiotic? No, nystatin is not an antibiotic, and it does not treat bacterial infections. It is an antifungal medicine that treats fungal infections of the mouth, stomach, and intestines. Nystatin does not treat invasive fungal infections that affect other organs in the body.

Mycostatin

Infants 200,000 units (2 mL) PO 4 times daily for 7 to 14 days; divide dose so that one-half of each dose is placed in each side of the mouth. Avoid feeding for 5 to 10 minutes. The FDA-approved duration is for at least 48 hours after clinical cure. Neonates 200,000 units (2 mL) PO 4 times daily for 7 to 14 days; divide dose so that one-half of each dose is placed in each side of the mouth. Avoid feeding for 5 to 10 minutes. The FDA-approved duration is for at least 48 hours after clinical cure.