Nystatin chemical structure
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Nystatin

Nystatin is a polyene antimycotic drug. Nystatin is considered a "clean" drug as it has no proven side effects. Candida spp. are sensitive to nystatin. more...

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Uses

Cutaneous, vaginal, mucosal and esophageal Candida infections can be treated with nystatin. Cryptococcus is also sensitive to nystatin. In the UK its license for treating neonatal oral thrush is restricted to those over the age of one month (miconazole is an appropriate alternative for younger babies).

Nystatin is often used as prophylaxis in patients who are at risk for fungal infections, such as AIDS patients with a low CD4+ count and patients receiving chemotherapy.

It is prescribed in units, with doses varying from 100,000 (for oral infections) to 1 million (for intestinal ones). As it is not absorbed from the gut, it is safe for oral use and does not have probelms of drug interactions.

Method of action

Like amphotericin B and natamycin, nystatin binds to ergosterol, the main component of the fungal cell membrane. When present in sufficient concentrations, it forms a pore in the membrane that leads to K+ leakage and death of the fungus. As mammals do not have ergosterol-based cell membranes, the drug only affects fungi.

Origin

Like many other antimycotics and antibiotics, nystatin is itself a fungal product. It was isolated from Streptomyces noursei in 1950 by Elizabeth Lee Haxen and Rachel Fuller Brown, who were doing research for the Division of Laboratories and Research of the New York State Department of Health. The soil sample where they discovered nystatin, was from the garden of Hazen's friends called Nourses, therefore the strain was called noursei. Hazen and Brown named nystatin after the New York State Public Health Department.

Brand names

  • Nystan® (oral tablets, topical ointment, and pessaries, Bristol-Myers Squibb)
  • Infestat®
  • Nystamont®
  • Nystop® (topical powder, Paddock)
  • Nystex®
  • Mykinac®
  • Nysert® (vaginal suppositories, Procter & Gamble)
  • Nystaform® (topical ointment, combined with iodochlorhydroxyquine and hydrocortisone; Bayer)
  • Nilstat® (vaginal tablet, Lederle)
  • Korostatin® (vaginal tablets, Holland Rantos)
  • Mycostatin® (vaginal tablets, Bristol-Myers Squibb)
  • Mycolog-II® (topical ointment, combined with triamcinolone; Apothecon)
  • Mytrex® (topical ointment, combined with triamcinolone)
  • Mykacet® (topical ointment, combined with triamcinolone)
  • Myco-Triacet II® (topical ointment, combined with triamcinolone)

Read more at Wikipedia.org


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Treating infections without antibiotics
From Townsend Letter for Doctors and Patients, 11/1/05 by Jacob Teitelbaum

Many people do not realize how many things they can do before resorting to using an antibiotic to clear an infection. If your patient is coming down with a respiratory infection such as a cold or the flu, I recommend that you try the following:

[ILLUSTRATION OMITTED]

* Give natural thymic hormone. This is available as a product called ProBoost from Klabin Marketing: 800-933-9440), and is a very effective immune stimulant. Dissolve the contents of one packet under your tongue three times a day and let it absorb there (any that is swallowed is destroyed). A study in CFS patients with markedly elevated Epstein-Barr antibody levels showed a dramatic drop in the antibody levels after six weeks of treatment with thymic hormone. Many physicians are finding that thymic hormone has been very helpful for CFS/FMS and other patients with acute or persistent viral, yeast, bowel, or other infections. I have found that using it for two or three days at the onset of an infection can shorten the length of the infection dramatically, and often stops it on the first day.

* Take 1,000 to 8,000 milligrams of vitamin C a day--enough to get diarrhea, then cut back to comfortable level.

* Suck on a zinc lozenge five to eight times a day. Make sure that the lozenges have at least 10 to 20 milligrams of zinc per lozenge. Less than this will not be effective. Zinc lozenges have been known to speed the time it takes to recover from a cold by about 40%. General Nutrition Centers sells a very good one.

* Drink plenty of water and hot caffeine-free tea (or hot water with lemon) and rest!

* Take Oscillococcinum, a homeopathic remedy available at most health food stores and some supermarkets, for flu-like symptoms such as chills, fever, achiness and/or malaise. It speeds healing and eases discomfort. It is best taken early in the infection--as soon as the patient has any Flu-like symptoms.

* For sinus infections, try nasal rinses. Dissolve 1/2 teaspoon of salt in a cup of lukewarm water. Inhale some of the solution about one inch up into your nose, one nostril at a time. Do this either by using a baby nose bulb or an eyedropper while lying down, or by sniffing the solution out of the palm of your hand while standing by a sink. Then gently blow your nose, being careful not to hurt your ears. Repeat the same process with the other nostril. Continue to repeat with each nostril until the nose is clear. Rinse your nasal passages at least twice a day until the infection improves. Each rinsing will wash away about 90% of the infection and make it much easier for your body to heal.

* 1,000 milligrams of olive leaf extract three times a day for three to seven days. Although probably not as effective as thymic hormone, olive leaf extract seems to be helpful against viral respiratory infections and, perhaps, yeast infections. It seems most helpful in fighting the common cold. In my experience, it has been very helpful for about half the people who try it--the cold is gone in twenty-four to thirty-six hours. If it causes nausea, cut the dose in half.

* Take acetaminophen (in Tylenol and many other over-the-counter pain relievers) for muscle aches and use Cepacol or Chloraseptic mouthwash as a gargle for a sore throat. Gargling with salt water, mixed as described above for the nasal rinse, also helps a sore throat. If you use acetaminophen frequently, you should also take 500 milligrams of supplemental N-acetylcysteine (NAC) each day so you don't deplete your glutathione levels.

* Try using a humidifier or vaporizer in your bedroom. You can also make a steam room by running a hot shower in your bathroom and then breathing in the steam. Or try using a steam inhaler, such as the one available from Bernhard Industries. This is also wonderful for chronic and acute sinusitis.

* Take at least 500 milligrams of vitamin C a day for prevention.

If, despite these measures, nasal and lung mucus is yellow after seven to fourteen days, or if you are feeling worse after three to four days, you may have to consider taking a course of antibiotics. If you do, you should take nystatin while on the antibiotic. Erythromycin antibiotics such as azithromycin (Zithromax) and clarithromycin (Biaxin) are usually preferable to penicillin antibiotics. Interestingly, my patients have sometimes found that all their CFIDS symptoms (not just the cold) improve while they are taking an erythromycin or tetracycline antibiotic. If that happens, I recommend a twelve-week course of 500 milligrams of Biaxin or 100 milligrams of doxycycline twice a day. If you feel better on the antibiotic (take thymic hormone, echinacea, and the antifungal nystatin in con-junction with it), keep repeating six-week courses until the symptoms stay gone. I would also check for Lyme disease using a blood or urine test. And for most of my patients who repeatedly get respiratory infections that take forever to go away, I consider an empiric trial of prescription hydrocortisone (Cortef) at a dosage of 7-1/2 milligrams in the morning and 5 milligrams at noon for two to three months.

As a preventive for respiratory infections, the flu vaccine is a double-edged sword for people with CFIDS/FMS. In some CFIDS/FMS patients, it can cause mild flulike symptoms for a few days. In rare cases, it can cause a severe flare-up of symptoms. Still, unless you are one of the 10% of CFIDS/FMS patients who feel worse after the flu shot or other vaccinations, I would get a flu shot. For most people, the benefit can significantly outweigh the risk. Interestingly, a recent Scandinavian study showed that having frequent vaccinations against Staphylococcus bacteria significantly improved symptoms in fibromyalgia patients. The researchers felt that it helped by stimulating the immune system.

Taking at least 500 milligrams of vitamin C a day is also a very good idea. And dress warmly. A cold breeze blowing across a patient's muscles can make fibromyalgia symptoms flare up.

Jacob Teitelbaum, MD is director of the Annapolis Research Center for Effective CFS/Fibromyalgia Therapies, which sees patients with CFS/FMS from all over the world (410-573-5389; www.EndFatigue.com) and author of the best selling book "From Fatigued to Fantastic!" and "Three Steps To Happiness! Healing Through Joy." His newest book "Pain Free 1-2-3!" has just been released. CD sets of his workshops on effective CFS/Fibromyalgia therapies and pain management for both prescribing and non-prescribing practitioners are available at www.vitality101.com. He accepts no money from any company whose products he recommends and 100% of his royalties for products he makes is donated to charity.

by Jacob Teitelbaum, MD

410-573-5389 * www.Vitality101.com.

COPYRIGHT 2005 The Townsend Letter Group
COPYRIGHT 2005 Gale Group

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