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Drug Design, Development and Therapy 2016To systematically review and assess the efficacy, different treatment protocols (formulation, dosage, and duration), and safety of nystatin for treating oral candidiasis. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To systematically review and assess the efficacy, different treatment protocols (formulation, dosage, and duration), and safety of nystatin for treating oral candidiasis.
METHODS
Four electronic databases were searched for trials published in English till July 1, 2015. Randomized controlled trials comparing nystatin with other antifungal therapies or a placebo were included. Clinical and/or mycological cure was the outcome evaluation. A meta-analysis or descriptive study on the efficacy, treatment protocols, and safety of nystatin was conducted.
RESULTS
The meta-analysis showed that nystatin pastille was significantly superior to placebo in treating denture stomatitis. Nystatin suspension was not superior to fluconazole in treating oral candidiasis in infants, children, or HIV/AIDS patients. The descriptive investigations showed that administration of nystatin suspension and pastilles in combination for 2 weeks might achieve a higher clinical and mycological cure rate, and using the nystatin pastilles alone might have a higher mycological cure rate, when compared with using nystatin suspensions alone. Nystatin pastilles at a dose of 400,000 IU resulted in a significantly higher mycological cure rate than that administrated at a dose of 200,000 IU. Furthermore, treatment with nystatin pastilles for 4 weeks seemed to have better clinical efficacy than treatment for 2 weeks. Descriptive safety assessment showed that poor taste and gastrointestinal adverse reaction are the most common adverse effects of nystatin.
CONCLUSION
Nystatin pastille was significantly superior to placebo in treating denture stomatitis, while nystatin suspension was not superior to fluconazole in treating oral candidiasis in infants, children, or HIV/AIDS patients. Indirect evidence from a descriptive study demonstrated that administration of nystatin pastille alone or pastille and suspension in combination is more effective than that of suspension alone; prolonged treatment duration for up to 4 weeks can increase the efficacy of nystatin. More well designed and high quality randomized control studies are needed to confirm these findings.
Topics: Candidiasis, Oral; Dose-Response Relationship, Drug; Humans; Nystatin
PubMed: 27042008
DOI: 10.2147/DDDT.S100795 -
The Medical Clinics of North America Sep 1970
Review
Topics: Candida; Candidiasis; Candidiasis, Cutaneous; Candidiasis, Oral; Candidiasis, Vulvovaginal; Female; Humans; Male; Nystatin; Ointments; Powders; Suppositories; Suspensions; Tablets
PubMed: 4919155
DOI: No ID Found -
Current Opinion in Investigational... Apr 2001Nystatin LF (Nyotran) is a liposomal, intravenous nystatin formulation under development by Aronex, under license from the MD Anderson Cancer Research Center, as a... (Review)
Review
Nystatin LF (Nyotran) is a liposomal, intravenous nystatin formulation under development by Aronex, under license from the MD Anderson Cancer Research Center, as a systemic antifungal agent against strains including Aspergillus and Candida. Like amphotericin, nystatin is a polyene derivative that binds to ergosterol, a fungal cell membrane component, creating a pore in the membrane and thus killing the cell. Nystatin is an established antifungal agent, but is restricted to topical use as it is ineffective orally and severely toxic when administered iv [187583], [187589]. It has demonstrated good, broad in vitro antifungal activity against clinically relevant filamentous fungi [319465], including fungi resistant to fluconazole and amphotericin B products [264505], [2869821, [287790], 1289522]. The company is also conducting a phase III trial to evaluate its efficacy against cryptococcal meningitis [305531], [334156]. Aronex filed for approval of nystatin LF in Spain in December 1997 [272986] and expected to file an NDA in the US by the end of 1999 1311208], [342003]. However, in an effort to ensure that its US and European filings contained data from the phase III cryptococcal meningitis trial in its entirety, Aronex's marketing partner requested that all the 70-day data be gathered prior to unblinding this study. The filing had initially been based on interim data at the 14- and 21-day endpoint 1344887]. In September 2000, the company anticipated an NDA filing in the US in the fourth quarter of 2001 1382861], 1387947]. In December 1997, Aronex, together with Grupo Ferrer Internacional, filed an MAA in Spain seeking approval for Nyotran for the treatment of systemic fungal infections. Aronex intended to follow the filing with additional filings in other European countries 1272986]. In 1997, a commercialization agreement was signed with Ferrer for Spain and Portugal, with Aronex intending to form other such partnerships throughout Europe and Asia 1248346]. In November 1998, Aronex signed a licensing collaboration with Abbott Laboratories for the worldwide rights to nystatin LF [305531].
Topics: Antifungal Agents; Clinical Trials as Topic; Drug Carriers; Humans; Liposomes; Nystatin; Structure-Activity Relationship
PubMed: 11566004
DOI: No ID Found -
Annals of the New York Academy of... Aug 1960
Topics: Mycoses; Nystatin
PubMed: 13712559
DOI: 10.1111/j.1749-6632.1960.tb20148.x -
Molecules (Basel, Switzerland) Dec 2021Understanding our oceans and their marine ecosystems has enabled the development of sustainable systems for mariculture. While the bulk of studies to date have focused...
Understanding our oceans and their marine ecosystems has enabled the development of sustainable systems for mariculture. While the bulk of studies to date have focused on the production of food, its remarkable expanse has inspired the translation of other markets towards aquatic environments. This manuscript outlines an approach to pharmaceutical mariculture, by demonstrating a benchmark for future prototyping. Here, design, field evaluation and natural product chemistry are united to successfully produce nystatin at sea. This study begins by evaluating new designs for culture flasks, illustrating a next step towards developing self-contained bioreactors for culturing in marine environments. Through pilot studies, an underwater system was developed to cost effectively produce cultures that yielded 200 mg of nystatin per deployment. Overall, this study demonstrates the potential for the practical culturing of microbes in a marine environment and provides an important next step for the fledgling field of molecular mariculture.
Topics: Aquaculture; Ecosystem; Nystatin; Oceans and Seas; Water Pollutants, Chemical
PubMed: 34946737
DOI: 10.3390/molecules26247649 -
Chemotherapia 1961
Topics: Nystatin
PubMed: 13723242
DOI: 10.1159/000219536 -
The Cochrane Database of Systematic... 2000Nystatin is sometimes used prophylactically in patients with severe immunodeficiency or in the treatment of fungal infection in such patients, although the effect seems... (Review)
Review
BACKGROUND
Nystatin is sometimes used prophylactically in patients with severe immunodeficiency or in the treatment of fungal infection in such patients, although the effect seems to be equivocal.
OBJECTIVES
To study whether nystatin decreases morbidity and mortality when given prophylactically or therapeutically to patients with severe immunodeficiency.
SEARCH STRATEGY
MEDLINE and The Cochrane Library using a comprehensive search strategy. Contacted industry and scanned reference lists.
SELECTION CRITERIA
Randomised trials comparing nystatin with placebo, an untreated control group, fluconazole or amphotericin B.
DATA COLLECTION AND ANALYSIS
Data on mortality, invasive fungal infection and colonisation were extracted by both authors independently. The outcomes were weighted by the inverse variance. A random effects model was used unless p>0.10 for the test of heterogeneity.
MAIN RESULTS
We included 10 trials (1, 122 patients). The drugs were given prophylactically in eight trials and as treatment in two. Six trials were in acute leukaemia, one mainly in cancer, one in liver transplant patients, one in critically ill surgical and trauma patients, and one in AIDS patients. Nystatin had been compared with placebo in three trials and with fluconazole in seven; the dose varied from 1.5 MIE to 72 MIE daily. The effect of nystatin was similar to that of placebo on fungal colonisation (relative risk 0.85, 95% confidence interval 0. 65 to 1.13). There was no difference between fluconazole and nystatin on mortality (relative risk 0.87, 0.52 to 1.44) whereas fluconazole was more effective in preventing invasive fungal infection (relative risk 0.42, 0.16 to 1.12) and colonisation (relative risk 0.50, 0.36 to 0.71). The results were very similar if the three studies which were not performed in cancer patients were excluded.
REVIEWER'S CONCLUSIONS
Nystatin cannot be recommended for prophylaxis or treatment of Candida infections in immunodepressed patients.
Topics: Antibiotic Prophylaxis; Antifungal Agents; Humans; Immunocompromised Host; Mycoses; Nystatin; Opportunistic Infections
PubMed: 10796846
DOI: 10.1002/14651858.CD002033 -
Advanced Drug Delivery Reviews Aug 2023Nystatin is an antifungal molecule with a remarkable yet squandered versatility. In this review, its mechanism of action is explored, along with its extensive action... (Review)
Review
Nystatin is an antifungal molecule with a remarkable yet squandered versatility. In this review, its mechanism of action is explored, along with its extensive action spectrum and toxicity. A multitude of methodologies to tackle the drug's physical and chemical hurdles are outlined along with some proven-effective strategies to increase its activity and/or decrease its toxicity. A separate detailed section focused on micro and nanotechnology solutions addresses new drug delivery systems made of polymeric, metallic or lipid materials. Although the topical route depicts greater representativeness amongst these formulations, the intravenous, dental, oral, vaginal and inhalation routes are also mentioned. The unsuccessful previous attempts at developing parenteral formulations of nystatin or even the withdrawal of a nystatin-loaded multilamellar liposome should not divert research away from this drug. In fact, the interest in nystatin ought to be reawakened with the ongoing clinical trials on the promising nystatin-like genetically engineered derivate BSG005.
Topics: Humans; Antifungal Agents; Nystatin; Liposomes; Drug Delivery Systems; Polymers
PubMed: 37348678
DOI: 10.1016/j.addr.2023.114969 -
The Japanese Journal of Physiology 1994We have reviewed the basic aspects of history, physicochemical properties, advantages, disadvantages, and applications of nystatin- and amphotericin B-perforated patch... (Review)
Review
We have reviewed the basic aspects of history, physicochemical properties, advantages, disadvantages, and applications of nystatin- and amphotericin B-perforated patch recording. Recently, we have developed a novel perforated patch technique using gramicidin [49, 132, 133]. Since gramicidin pores are permeable to Na+ and K+ but not to Cl-, it is possible to maintain the physiological concentration of intracellular Cl- and thereby to measure it in real-time from small neurons. Further improvement of the perforated patch techniques would be possible by limiting redistribution of specific intracellular ions. In light of their broad applicability, the perforated patch techniques will prove indispensable for electrophysiologists working on the functions and modulations of receptors, ion channels and transport phenomena. Research with the perforated patch should continue to provide important information relevant to the physiological and pathological conditions of cells.
Topics: Animals; Calcium Channels; Glutamates; Hippocampus; Ion Channels; Ionophores; Nystatin; Patch-Clamp Techniques; Potassium Channels; Pyramidal Cells; Rats; Sodium Channels; Substantia Innominata
PubMed: 7534361
DOI: 10.2170/jjphysiol.44.433 -
Applied Microbiology and Biotechnology Jun 2005The polyene macrolide antibiotic nystatin, produced commercially by the bacterium Streptomyces noursei, is an important antifungal agent used in human therapy for... (Review)
Review
The polyene macrolide antibiotic nystatin, produced commercially by the bacterium Streptomyces noursei, is an important antifungal agent used in human therapy for treatment of certain types of mycoses. Early studies on nystatin biosynthesis in S. noursei provided important information regarding the precursors utilised in nystatin biosynthesis and factors affecting antibiotic yield. New insights into the enzymology of nystatin synthesis became available after the gene cluster governing nystatin biosynthesis in S. noursei was cloned and analysed. Six large polyketide synthase proteins were implicated in the formation of the nystatin macrolactone ring, while other enzymes, such as P450 monooxygenases and glycosyltransferase, were assumed responsible for ring "decoration". The latter data, supported by analysis of the polyene mixture synthesised by the nystatin producer, helped elucidate the complete nystatin biosynthetic pathway. This information has proved useful for engineered biosynthesis of novel nystatin analogues, suggesting a plausible route for the generation of potentially safer and more efficient antifungal drugs.
Topics: Antifungal Agents; Bacterial Proteins; Biotechnology; Gene Expression Regulation, Bacterial; Nystatin; Streptomyces
PubMed: 15700127
DOI: 10.1007/s00253-004-1802-4