nystatin-a1 and Mycoses

Fungi, which can cause serious infections, results in more than 1.35 million deaths annually throughout the world. Azole antifungal drugs which could inhibit the enzyme lanosterol 14α-demethylase, occupy an important position in the treatment of fungal infections. Tetrazoles, practically non-metabolized bioisosteric analog of carboxylic acid and cis-amide, possess a variety of chemotherapeutic properties, including antifungal activities. Hybridization represents a promising strategy to develop novel drugs, and hybridization of tetrazole with other antifungal pharmacophores has the potential to increase the activity and overcome the drug resistance. Various tetrazole hybrids have been designed, synthesized and screened for their antifungal activities, and some of them showed promising activity against both drug-susceptible and drug-resistant fungi. In this review, we present tetrazole hybrids for fighting against fungi. The structure-activity relationship (SAR) is also discussed to provide an insight for rational designs of more effective candidates.

Topics: Animals; Antifungal Agents; Azoles; Fungi; Humans; Mycoses; Pyridines; Pyrimidines; Quinolines; Structure-Activity Relationship; Tetrazoles

Invasive fungal infection is an important cause of mortality and morbidity in very preterm or very low birth weight infants. Uncertainty exists about the effect of prophylactic oral/topical non-absorbed antifungals to reduce mucocutaneous colonisation and so limit the risk of invasive fungal infection in this population.. To assess the effect of prophylactic oral/topical non-absorbed antifungal therapy on the incidence of invasive fungal infection, mortality and morbidity in very preterm or very low birth weight infants.. We used the standard search strategy of the Cochrane Neonatal Review Group. This included searches of the Cochrane Central Register of Controlled Trials (CENTRAL: The Cochrane Library, 2015, Issue 7), MEDLINE, EMBASE, and CINAHL (to May 2015), conference proceedings, and previous reviews.. Randomised controlled trials or quasi-randomised controlled trials that compared the effect of prophylactic oral/topical non-absorbed antifungal therapy versus placebo or no drug or another antifungal agent or dose regimen in very preterm or very low birth weight infants.. We extracted data using the standard methods of the Cochrane Neonatal Review Group with separate evaluation of trial quality and data extraction by two review authors.. Four trials, in which a total of 1800 infants participated, compared oral/topical non-absorbed antifungal prophylaxis (nystatin or miconazole) with placebo or no drug. These trials had various methodological weaknesses including quasi-randomisation, lack of allocation concealment, and lack of blinding of intervention and outcomes assessment. The incidence of invasive fungal infection was very high in the control groups of three of these trials. Meta-analysis found a statistically significant reduction in the incidence of invasive fungal infection (typical risk ratio 0.20, 95% confidence interval 0.14 to 0.27; risk difference -0.18, -0.21 to -0.15) but substantial statistical heterogeneity was present. We did not find a statistically significant effect on mortality (typical risk ratio 0.87, 0.72 to 1.05; risk difference -0.03, -0.06 to 0.01). None of the trials assessed posthospital discharge outcomes. Three trials (N = 326) assessed the effect of oral/topical non-absorbed versus systemic antifungal prophylaxis. Meta-analyses did not find any statistically significant differences in the incidences of invasive fungal infection or all-cause mortality.. The finding of a reduction in risk of invasive fungal infection in very low birth weight infants treated with oral/topical non-absorbed antifungal prophylaxis should be interpreted cautiously because of methodological weaknesses in the included trials. Further large randomised controlled trials in current neonatal practice settings are needed to resolve this uncertainty. These trials might compare oral/topical non-absorbed antifungal agents with placebo, with each other, or with systemic antifungal agents and should include an assessment of effect on long-term neurodevelopmental outcomes.

Topics: Administration, Oral; Administration, Topical; Antifungal Agents; Fluconazole; Humans; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases; Infant, Very Low Birth Weight; Miconazole; Mycoses; Nystatin; Randomized Controlled Trials as Topic

Nystatin is sometimes used prophylactically in patients with severe immunodeficiency or in the treatment of fungal infection in such patients, although its effect seems to be equivocal.. To study whether nystatin decreases morbidity and mortality when given prophylactically or therapeutically to patients with severe immunodeficiency.. We searched PubMed from 1966 to 7 July 2014 and the reference lists of identified articles.. Randomised clinical trials comparing nystatin with placebo, an untreated control group, fluconazole or amphotericin B.. Data on mortality, invasive fungal infection and colonisation were independently extracted by both authors. A random-effects model was used unless the P value was greater than 0.10 for the test of heterogeneity.. We included 14 trials (1569 patients). The drugs were given prophylactically in 12 trials and as treatment in two. Eleven trials were in acute leukaemia, solid cancer, or bone marrow recipients; one in liver transplant patients; one in critically ill surgical and trauma patients; and one in AIDS patients. Nystatin was compared with placebo in three trials, with fluconazole in 10, and amphotericin B in one; the dose varied from 0.8 MIE to 72 MIE daily and was 2 mg/kg/d in a liposomal formulation. The effect of nystatin was similar to that of placebo on fungal colonisation (relative risk (RR) 0.85, 95% confidence interval (CI) 0.65 to 1.13). There was no statistically significant difference between fluconazole and nystatin on mortality (RR 0.75, 95% CI 0.54 to 1.03) whereas fluconazole was more effective in preventing invasive fungal infection (RR 0.40, 95% CI 0.17 to 0.93) and colonisation (RR 0.50, 95% CI 0.36 to 0.68). There were no proven fungal infections in a small trial that compared amphotericin B with liposomal nystatin. The results were very similar if the three studies that were not performed in cancer patients were excluded. For the 2011 and 2014 updates no additional trials were identified for inclusion.. Nystatin cannot be recommended for prophylaxis or the treatment of Candida infections in immunodepressed patients.

Topics: Amphotericin B; Antibiotic Prophylaxis; Antifungal Agents; Candidiasis; Fluconazole; Humans; Immunocompromised Host; Liposomes; Mycoses; Nystatin; Opportunistic Infections; Randomized Controlled Trials as Topic

Systemic fungal infection is considered to be an important cause of morbidity and mortality in cancer patients, particularly those with neutropenia. Antifungal drugs are often given prophylactically, or empirically to patients with persistent fever.. To compare the effect of fluconazole and amphotericin B on morbidity and mortality in patients with cancer complicated by neutropenia.. We searched PubMed from 1966 to 7 July 2014 and the reference lists of identified articles.. Randomised clinical trials comparing fluconazole with amphotericin B.. The two review authors independently assessed trial eligibility and risk of bias, and abstracted data.. Seventeen trials (3798 patients, 381 deaths) were included. In two large three-armed trials, results for amphotericin B were combined with results for nystatin in a 'polyene' group. Because nystatin is an ineffective drug in these circumstances, this approach creates a bias in favour of fluconazole. Furthermore, most patients were randomised to oral amphotericin B, which is poorly absorbed and poorly documented. There was overlap among the 'polyene' trials but we were unable to obtain any information from the trial authors or from Pfizer, the manufacturer of fluconazole, to clarify these issues. There were no significant differences in effect between fluconazole and amphotericin B, but the confidence intervals were wide. More patients dropped out of the study when they received amphotericin B, but as none of the trials were blinded decisions on premature interruption of therapy could have been biased. Furthermore, amphotericin B was not given under optimal circumstances, with premedication to reduce infusion-related toxicity, slow infusion, and with fluid, potassium and magnesium supplements to prevent nephrotoxicity. The major harms were hepatic impairment and gastrointestinal adverse effects with fluconazole and infusion-related toxicity, renal impairment and gastrointestinal adverse effects with amphotericin B. For the 2011 and 2014 updates no additional trials were identified for inclusion.. Amphotericin B has been disfavoured in several of the trials through their design or analysis, or both. Since intravenous amphotericin B is the only antifungal agent for which an effect on mortality has been shown, and since it is considerably cheaper than fluconazole, it should be the preferred agent.

Topics: Administration, Oral; Amphotericin B; Antifungal Agents; Confidence Intervals; Fluconazole; Humans; Injections, Intravenous; Mycoses; Neoplasms; Neutropenia; Nystatin; Odds Ratio; Randomized Controlled Trials as Topic

Invasive fungal infection is an important cause of mortality and morbidity in very preterm or very low birth weight infants. Uncertainty exists about the effect of prophylactic oral/topical non-absorbed antifungals to reduce mucocutaneous colonisation and so limit the risk of invasive fungal infection in this population.. To assess the effect of prophylactic oral/topical non-absorbed antifungal therapy on the incidence of invasive fungal infection, mortality and morbidity in very preterm or very low birth weight infants.. We used the standard search strategy of the Cochrane Neonatal Review Group. This included searches of the Cochrane Central Register of Controlled Trials (CENTRAL: The Cochrane Library, 2012, Issue 3), MEDLINE, EMBASE, and CINAHL (to August 2012), conference proceedings, and previous reviews.. Randomised controlled trials or quasi-randomised controlled trials that compared the effect of prophylactic oral/topical non-absorbed antifungal therapy versus placebo or no drug or another antifungal agent or dose regimen in very preterm or very low birth weight infants.. We extracted data using the standard methods of the Cochrane Neonatal Review Group with separate evaluation of trial quality and data extraction by two review authors.. Four trials, in which a total of 1800 infants participated, compared oral/topical non-absorbed antifungal prophylaxis (nystatin or miconazole) with placebo or no drug. These trials had various methodological weaknesses including quasi-randomisation, lack of allocation concealment, and lack of blinding of intervention and outcomes assessment. The incidence of invasive fungal infection was very high in the control groups of three of these trials. Meta-analysis found a statistically significant reduction in the incidence of invasive fungal infection [typical risk ratio 0.20 (95% confidence interval 0.14 to 0.27); risk difference -0.18 (-0.21 to -0.16)] but substantial statistical heterogeneity was present. We did not find a statistically significant effect on mortality [typical risk ratio 0.87 (0.72 to 1.05); risk difference -0.03 (-0.06 to 0.01)]. None of the trials assessed posthospital discharge outcomes.Two trials (N = 265) assessed the effect of oral/topical non-absorbed versus systemic antifungal prophylaxis. Meta-analyses did not find any statistically significant differences in the incidences of invasive fungal infection or all-cause mortality.. The finding of a reduction in risk of invasive fungal infection in very low birth weight infants treated with oral/topical non-absorbed antifungal prophylaxis should be interpreted cautiously because of methodological weaknesses in the included trials. Further large randomised controlled trials in current neonatal practice settings are needed to resolve this uncertainty. These trials might compare oral/topical non-absorbed antifungal agents with placebo, with each other, or with systemic antifungal agents and should include an assessment of effect on long-term neurodevelopmental outcomes.

Topics: Administration, Oral; Administration, Topical; Antifungal Agents; Fluconazole; Humans; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases; Infant, Very Low Birth Weight; Miconazole; Mycoses; Nystatin; Randomized Controlled Trials as Topic

In recent years their has been an increased use of antifungal agents and has resulted in the development of resistance to drugs. Currently, use of standard antifungal therapies can be limited because of toxicity, low efficacy rates. Different types of mechanisms contribute to the development of resistance to antifungals. This has given raise to search for a new heterocycle with distinct action or multitargeted combination therapy. This review addresses the areas such as the underlying mechanisms, eight different targets such as ergosterol synthesis, chitin synthesis, ergosterol disruptors, glucan synthesis, squalene epoxidase, nucleic acid synthesis, protein synthesis, microtubules synthesis. The clinically employed drugs along with the current research work going on worldwide on different heterocycles are discussed. In recent advances various heterocycles including imidazole, benzimidazole etc., twenty three scaffolds and their lead identification are discussed.

Topics: Animals; Antifungal Agents; Azoles; Fungi; Humans; Imidazoles; Mycoses

To review the use of antifungal chemoprophylaxis to prevent neonatal invasive fungal infections (IFI) in very low birthweight infants (VLBW <1500 g).. Systematic review of randomised controlled trials.. Nine trials were identified (2029 infants), with six comparing fluconazole with placebo/no treatment (840 infants), three comparing nystatin with placebo/no treatment (1200 infants) and two comparing fluconazole and nystatin (257 infants). Prophylactic fluconazole reduced the incidence of IFI in VLBW infants <1500 g to 5.1% compared with 16.0% in infants receiving placebo, relative risk (RR) = 0.36 (95% confidence interval 0.15-0.89). The mortality was 10.9% and 16.7%, respectively (RR 0.76, 0.54-1.08). Oral nystatin reduced the incidence of IFI in VLBW infants to 5.3% compared with 28.0% in infants receiving placebo (RR 0.16, 0.11-0.23). Mortality was 7.5% with nystatin and 10.9% with placebo (RR 0.86, 0.59-1.26). The incidence of IFI in studies comparing fluconazole and nystatin was 3.6% and 8.0%, respectively (RR 0.54, 0.19-1.56), and mortality was not significantly different: 4.6% versus 9.8% (RR 0.43, 0-4.31). Prophylactic fluconazole and oral nystatin are both highly effective in preventing IFI in VLBW infants. Both agents are safe without significant toxicities. Antifungal prophylaxis should therefore be used in all VLBW infants. Given the paucity of data comparing fluconazole with nystatin, the choice of antifungal agent should be influenced by the incidence of IFI, local epidemiology and relative cost.

Topics: Antifungal Agents; Fluconazole; Humans; Infant, Newborn; Infant, Very Low Birth Weight; Mycoses; Nystatin; Randomized Controlled Trials as Topic; Treatment Outcome

To examine recent evidence on the efficacy of antifungal prophylaxis to prevent neonatal systemic fungal infection. The review also aims to examine other relevant data, including the incidence of fungal infection, adverse effects of antifungal therapy and avoidable risk factors.. There is strong evidence that systemic fluconazole prophylaxis reduces the incidence of systemic fungal infections, with a trend towards reduction in mortality. However, the preprophylaxis incidence of fungal infection has been very high in the published studies. Fluconazole use is sometimes associated with cholestasis and there are theoretical concerns as well that prophylactic fluconazole will select for fluconazole-resistant organisms and nonalbicans Candida infections. There is reasonable evidence that oral nystatin is effective in preventing fungal infections and at the same time it is inexpensive and well tolerated. The reported incidence of systemic fungal infections is much lower in the UK than in the USA and Italy.. Oral nystatin prophylaxis is inexpensive, effective and nontoxic and should be used routinely for babies of birth weight less than 1500 g. Systemic fluconazole, which is more toxic and may select for resistant fungi, is probably only indicated when the rate of fungal infection remains high despite introducing measures targeting known risk factors for fungal infection. These measures include introducing enteral feeds early, reducing the duration of parenteral feeding, and reducing the use of broad spectrum antibiotics, particularly cephalosporins. Future studies of prophylactic fluconazole should use oral nystatin, not placebo, as the comparator.

Topics: Administration, Oral; Antifungal Agents; Cross Infection; Fluconazole; Humans; Infant, Newborn; Infant, Very Low Birth Weight; Mycoses; Nystatin; Risk Factors

Fungi, in comparison with other pathogenic factors, have high pathogenicity. The number of fungal species which are able to infect people is over 500. The upper respiratory tract and ear have permanent contact with external environment which makes their ontocenoses open to continuous exchange of microorganisms of which they consist. In etiology of inflammatory processes 21 species which belonging to 3 genera (Zygomycota, Ascomycota, Basidiomycota) of fungi play important role. Administration of antifungal drugs can be: prophylactic, empiric preemptive and therapeutic. Physicians may prescribe antibiotics (mainly pollens: amphotericin B, natamycin and nystatin) and chemiotherapeutics (mainly azoles and fluorpirymidins, pigments, chlorhexidine and chlorquinaldol). In ENT practice topical and systemic drugs can be administrated. Topical lozenges include amphotericin B, clotrimazole, chlorhexidine or chlorquinaldol and oral gels: nystatin and miconazole. Some of drugs are in the form of suspension/solution, which can be used for inhalation, into the sinus, for swabbing or for lavage: amphotericin B, natamycin, nystatin, clotrimazol, flucytosine, miconazole, fluconazole, vorykonazole, caspofungin. It should be underlined that only a few of dugs can be absorbed from the digestive tract: flucytosine, fluconazole, itraconazole, ketoconazole, miconazole, vorykonazole.

Topics: Administration, Inhalation; Administration, Oral; Administration, Topical; Amphotericin B; Antifungal Agents; Azoles; Clotrimazole; Ear Diseases; Humans; Miconazole; Mycoses; Nystatin; Otitis; Respiratory Tract Infections

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.. To study whether nystatin decreases morbidity and mortality when given prophylactically or therapeutically to patients with severe immunodeficiency.. MEDLINE and The Cochrane Library using a comprehensive search strategy, date of last search November 2001. Contacted industry and scanned reference lists.. Randomised trials comparing nystatin with placebo, an untreated control group, fluconazole or amphotericin B.. Data on mortality, invasive fungal infection and colonisation were extracted by both authors independently. A random effects model was used unless p>0.10 for the test of heterogeneity.. We included 12 trials (1,464 patients). The drugs were given prophylactically in ten trials and as treatment in two. Seven trials were in acute leukaemia, two 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 nine; 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 statistically significant difference between fluconazole and nystatin on mortality (relative risk 0.76, 0.49 to 1.18) whereas fluconazole was more effective in preventing invasive fungal infection (relative risk 0.37, 0.15 to 0.91) and colonisation (relative risk 0.49, 0.34 to 0.70). The results were very similar if the three studies which were not performed in cancer patients were excluded.. Nystatin cannot be recommended for prophylaxis or treatment of Candida infections in immunodepressed patients.

Topics: Amphotericin B; Antibiotic Prophylaxis; Antifungal Agents; Fluconazole; Humans; Immunocompromised Host; Mycoses; Nystatin; Opportunistic Infections; Randomized Controlled Trials as Topic

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.. To study whether nystatin decreases morbidity and mortality when given prophylactically or therapeutically to patients with severe immunodeficiency.. MEDLINE and The Cochrane Library using a comprehensive search strategy, date of last search November 2001. Contacted industry and scanned reference lists.. Randomised trials comparing nystatin with placebo, an untreated control group, fluconazole or amphotericin B.. 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.. We included 12 trials (1,464 patients). The drugs were given prophylactically in ten trials and as treatment in two. Seven trials were in acute leukaemia, two 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 nine; 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 statistically significant difference between fluconazole and nystatin on mortality (relative risk 0.76, 0.49 to 1.18) whereas fluconazole was more effective in preventing invasive fungal infection (relative risk 0.37, 0.15 to 0.91) and colonisation (relative risk 0.49, 0.34 to 0.70). The results were very similar if the three studies which were not performed in cancer patients were excluded.. Nystatin cannot be recommended for prophylaxis or treatment of Candida infections in immunodepressed patients.

Topics: Amphotericin B; Antibiotic Prophylaxis; Antifungal Agents; Fluconazole; Humans; Immunocompromised Host; Mycoses; Nystatin; Opportunistic Infections

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.. To study whether nystatin decreases morbidity and mortality when given prophylactically or therapeutically to patients with severe immunodeficiency.. MEDLINE and The Cochrane Library using a comprehensive search strategy. Contacted industry and scanned reference lists.. Randomised trials comparing nystatin with placebo, an untreated control group, fluconazole or amphotericin B.. 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.. 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.. 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

Patients with cancer and infectious disease often display dyslipidemias that result in changes in their plasma lipoprotein-lipid composition. It is likely that the interactions of liposomal polyenes with plasma lipoproteins may be responsible for the far different pharmacokinetics and pharmacodynamics of these compounds when they are administered to infected patients rather than to animals or healthy volunteers. Amphotericin B (AmpB) and nystatin are examples of such polyenes. Amphotericin B initially distributes with the high-density lipoprotein (HDL) fraction upon incubation in plasma. Over time, AmpB redistributes from HDLs to low-density lipoproteins (LDLs). This redistribution appears to be regulated by lipid transfer protein. However, when AmpB is incorporated into liposomes composed of negatively or positively charged phospholipids, not only is the capability of LTP to transfer AmpB from HDL to LDL diminished, but AmpB remains retained with only the HDL fraction. However, when liposomal nystatin is incubated in plasma, over 50% of nystatin distributes with HDLs. Over time, nystatin redistributes from HDL to the lipoprotein-deficient plasma fraction, which is composed of mainly aqueous plasma proteins. The lipid composition selected for the drug appears to be a vital constituent in regulating the drug's interaction with biological fluids. Furthermore, liposome (or liposomal particle) size, fluidity, and other physiochemical characteristics also play a role in altering the pharmacokinetics and pharmacological effects of lipid-based drug formulations. Armed with this understanding, a rational approach to clinical development of these formulations could be facilitated.

Topics: Amphotericin B; Anti-Bacterial Agents; Antifungal Agents; Humans; Immunocompromised Host; Kidney; Lipoproteins; Liposomes; Mycoses; Nystatin; Phagocytes

Topics: Amphotericin B; Antifungal Agents; Aspergillosis; Bone Marrow Transplantation; Candidiasis; Candidiasis, Chronic Mucocutaneous; Clinical Trials as Topic; Cryptococcosis; Double-Blind Method; Fluconazole; Humans; Itraconazole; Ketoconazole; Mucormycosis; Mycoses; Neutropenia; Nystatin; Primary Prevention; Recurrence; Retrospective Studies

During the last three years, several studies have investigated the potential of ketoconazole for antifungal prophylaxis in immunocompromised patients. Ketoconazole 200 mg o.d. seems to have some effect, but this daily dose is considered too low. Studies using higher doses suggest an increased prophylactic effect with 400 mg and adequate prophylaxis with 600 mg ketoconazole daily. When compared with other antifungals, ketoconazole seems to be superior to nystatin and as effective as amphotericin B (500 mg t.i.d.).

Topics: Amphotericin B; Drug Administration Schedule; Humans; Immunosuppression Therapy; Ketoconazole; Miconazole; Mycoses; Nystatin

As invasive fungal infection remains a common problem in the management of cancer patients, chemoprophylaxis of these opportunistic infections is desperately needed. The most frequently investigated antifungal agents have been nystatin, amphotericin B, and ketoconazole. In placebo-controlled studies, high doses of antifungal agents decreased the positive results from surveillance cultures, and there is some suggestion that such chemoprophylaxis may reduce the incidence of invasive candidiasis in neutropenic cancer patients. However, no oral chemoprophylaxis has effectively prevented aspergillosis or mucormycoses in these patients. There are still many areas of controversy, and the most adequate regimens, if any, remain to be defined.

Topics: Administration, Oral; Administration, Topical; Amphotericin B; Antifungal Agents; Candidiasis; Clinical Trials as Topic; Humans; Ketoconazole; Miconazole; Mycoses; Neoplasms; Nystatin

Hospital acquired infections due to fungi are primarily caused by yeast species of the genus Candida and mould species of the genus Aspergillus. Underlying disease with severely impaired defence mechanisms as well as certain forms of immunosuppressive and aggressive chemotherapy are the most important prerequisites for such secondary fungal infections. Aspergillus spec. usually infect man via exogenous routes, whereas Candida spec. mostly originate from the patient's own microbial flora. Under certain circumstances invasion of tissues follows (endomycoses). Exogenous Candida infections may likewise occur through contaminated hands of personnel and medical devices. The density of yeast cell distribution in hospital wards decreases with the distance from the primary source: the Candida infected human patient. Preventive measures protecting the patient at risk include: Permanent surveillance by routine cultural and serological examinations for the detection of an early infection of the skin, mouth, oesophagus, urinary tract, vagina and the bowel. Monitoring of patients is essential for early detection of dissemination and contributes to the control of fungal decontamination measures. Selective local decontamination is effected by the use of nonabsorbable compounds such as nystatin and amphotericin B in the gastrointestinal tract, and in oral and genital mucous membranes. Oral administration of ketoconazole has also been recommended. For the disinfection of skin appropriate chemicals are available. In the control of the environment of the endangered patient special attention must be paid to meticulous management of catheters.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Amphotericin B; Aspergillus; Candida; Catheters, Indwelling; Cross Infection; Cryptococcus neoformans; Disinfection; Environmental Microbiology; Humans; Hygiene; Microbiological Techniques; Mycoses; Nystatin; Patient Isolators; Species Specificity

Fungal infections of the gastrointestinal tract have risen to higher levels of prevalence in the past decade. Major factors accounting for this increase are social changes, such as the increased ease and frequency of travel, which exposes the individual to environmental conditions that may result in fungal infection; increasing use of antibiotic and hormonal medications by otherwise healthy persons; and improved therapy for other diseases, such as polychemotherapy of cancer with its immunosuppressive effects. Both noninvasive and invasive fungal disease of the intestinal tract in otherwise healthy individuals can be successfully treated. The invasive fungal infections in patients with severe prior underlying disease are often first diagnosed postmortem, but improvement in serologic techniques now offers a possibility of earlier diagnosis and therapeutic intervention.

Topics: Amphotericin B; Antifungal Agents; Candidiasis; Diarrhea; Enteritis; Histoplasmosis; Humans; Imidazoles; Immunosuppression Therapy; Ketoconazole; Miconazole; Mycoses; Neoplasms; Nystatin; Paracoccidioidomycosis; Piperazines; Sulfadiazine

Before 1950 no reliable or safe therapy existed for systemic and invasive mycoses, and only traditional and empirical topical preparations were available for dermatomycoses. Two distinct eras of rapid progress in antifungal therapy followed: first, in the 1950's came the introduction of the polyenes, nystatin and pimaricin for cutaneous, vaginal and intestinal candidiasis, and amphotericin B for the treatment of severe systemic mycoses. The second phase saw the successful introduction and clinical use of 5-fluorocytosine and several imidazole derivatives some twenty years later, at a time when the vast increase in iatrogenic systemic mycoses caused by opportunistic fungi had created an urgent and pressing need for new agents in addition to those still effective.

Topics: Amphotericin B; Antifungal Agents; Blastomycosis; Candidiasis; Flucytosine; Humans; Imidazoles; Mycoses; Natamycin; Nystatin; Polyenes

Topics: Amphotericin B; Antifungal Agents; Cell Membrane; Chemical Phenomena; Chemistry; Clotrimazole; Drug Resistance, Microbial; Drug Therapy, Combination; Flucytosine; Fungi; Griseofulvin; Miconazole; Microtubules; Mitosis; Mycoses; Nystatin; Phenyl Ethers; Structure-Activity Relationship; Tolnaftate

Topics: Administration, Topical; Amphotericin B; Candidiasis; Coccidioides; Flucytosine; Fusarium; Griseofulvin; Histoplasma; Humans; Mycoses; Natamycin; Nystatin; Streptomyces

Topics: Amphotericin B; Antifungal Agents; Chronic Disease; Flucytosine; Humans; Imidazoles; Mycoses; Natamycin; Nystatin; Peptides; Polyenes; Trityl Compounds

Topics: Adult; Child; Child, Preschool; Dermatitis, Contact; Drug Eruptions; Female; Hair; Humans; Ichthyosis; Male; Methotrexate; Mycoses; Nails; Nystatin; Photosensitivity Disorders; Polycythemia; Skin; Skin Diseases; Skin Neoplasms; United States

Topics: Alkenes; Amphotericin B; Animals; Antifungal Agents; Aspergillus; Benzene Derivatives; Candida; Dermatomycoses; Flucytosine; Griseofulvin; Humans; Imidazoles; Kinetics; Mice; Microsporum; Mycoses; Natamycin; Nystatin; Trichophyton

Topics: Amphotericin B; Anti-Bacterial Agents; Antifungal Agents; Cytosine; Fluorine; Griseofulvin; Humans; Mycoses; Nystatin; Penicillin G; Peptides; Potassium Iodide; Stilbamidines; Sulfonamides

Topics: Adult; Amphotericin B; Candidiasis; Female; Gastrointestinal Diseases; Histoplasmosis; Humans; Infant; Leukemia; Lymphoma; Male; Mucormycosis; Mycoses; Nystatin

Topics: Actinomycosis; Adolescent; Adult; Amphotericin B; Animals; Aspergillosis; Basidiomycota; Blastomycosis; Candidiasis; Cephalosporins; Child; Chromoblastomycosis; Coccidioidomycosis; Conjunctiva; Cryptococcosis; Drug Synergism; Eye Diseases; Female; Fungi; Geotrichosis; Guinea Pigs; Histoplasmosis; Humans; Male; Mucor; Mycetoma; Mycoses; Natamycin; Nystatin; Penicillium; Pityriasis; Rabbits; Rhinosporidiosis; Sporotrichosis; Tinea

Topics: Actinomycosis; Amphotericin B; Anti-Bacterial Agents; Aspergillosis; Blastomycosis; Candidiasis; Coccidioidomycosis; Cryptococcosis; Griseofulvin; Histoplasmosis; Humans; Iodides; Mucormycosis; Mycoses; Nocardia Infections; Nystatin; Penicillins; Sporotrichosis; Stilbamidines; Sulfadiazine; Surgical Procedures, Operative; Toxicology

Systemic fungal infection (SFI) is one of leading causes of morbidity and mortality in very low birth weight (VLBW) preterm infants. Because early diagnosis of SFI is challenging due to nonspecific manifestations, prophylaxis becomes crucial. This study aimed to assess effectiveness of oral nystatin as an antifungal prophylaxis to prevent SFI in VLBW preterm infants.. A prospective, open-labelled, randomized controlled trial was performed in a neonatal intensive care unit (NICU) of an academic hospital in Indonesia. Infants with a gestational age ≤ 32 weeks and/or birth weight of ≤ 1500 g with risk factors for fungal infection were assessed for eligibility and randomized to either an intervention group (nystatin) or control group. The intervention group received 1 ml of oral nystatin three times a day, and the control group received a dose of 1 ml of sterile water three times a day. The incidence of fungal colonization and SFI were observed and evaluated during the six-week study period. Overall mortality rates and nystatin-related adverse drug reactions during the study period were also documented.. A total of 95 patients were enrolled. The incidence of fungal colonization was lower among infants in nystatin group compared to those in control group (29.8 and 56.3%, respectively; relative risk 0.559; 95% confidence interval 0.357-0.899; p-value = 0.009). There were five cases of SFI, all of which were found in the control group (p-value = 0.056). There was no difference in overall mortality between the two groups. No adverse drug reactions were noted during the study period.. Nystatin is effective and safe as an antifungal prophylactic medication in reducing colonization rates in the study population. Whilst the use of nystatin showed a potential protective effect against SFI among VLBW preterm infants, there was no statistical significant difference in SFI rates between groups.. NCT03390374. Registered 4 January 2018 - Retrospectively registered.

Topics: Antifungal Agents; Fluconazole; Humans; Indonesia; Infant; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases; Infant, Very Low Birth Weight; Mycoses; Nystatin; Prospective Studies

This study aims to compare the efficacy of orally administered Saccharomyces boulardii versus nystatin in prevention of fungal colonization and invasive fungal infections in very low birth weight infants.. A prospective, randomized comparative study was conducted in preterm infants with a gestational age of ≤ 32 weeks and birth weight of ≤ 1,500 g. They were randomized into two groups, to receive S. boulardii or nystatin. Skin and stool cultures were performed for colonization and blood cultures for invasive infections, weekly.. A total of 181 infants were enrolled (S. boulardii group, n = 91; nystatin group, n = 90). Fungal colonization of the skin (15.4 vs 18.9 %, p = 0.532) and the stool (32.2 vs 27 %, p = 0.441) were not different between the probiotic and nystatin groups. Two patients had Candida-positive blood culture in the nystatin group whereas none in the probiotic group. Feeding intolerance, clinical sepsis, and number of sepsis attacks were significantly lower in the probiotics group than in the nystatin group.. Prophylactic S. boulardii supplementation is as effective as nystatin in reducing fungal colonization and invasive fungal infection, more effective in reducing the incidence of clinical sepsis and number of sepsis attacks and has favorable effect on feeding intolerance.

Topics: Antifungal Agents; Feces; Female; Fungi; Humans; Infant; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases; Infant, Very Low Birth Weight; Male; Mycoses; Nystatin; Probiotics; Prospective Studies; Saccharomyces; Skin; Treatment Outcome

To observe the effect of nystatin on incidence of invasive fungal infections (IFI) and the prognosis of mechanically ventilated critically ill patients.. A prospective study was conducted. Critical ill patients admitted to Department of Critical Care Medicine of Jiangxi Provincial People's Hospital from May 1st, 2012 to April 30th, 2013 needing mechanical ventilation were enrolled. The patients were randomly divided into two groups by envelope method. Patients in the nystatin group were administered nystatin 1000 kU three times a day via the gastric tube; and patients in the control group were given gastrointestinal prokinetic drug as placebo. The specimens were collected every 3 days throughout the ICU stay (T0, T3, T6, T9), the strain distribution was observed, and the corrected colonization index (CCI) of all patients were calculated. The incidence of candidemia and 28-day mortality as well as the duration of stay in ICU and hospital were also recorded.. A total of 874 strains were isolated from 124 patients, of which Candida albicans accounted for 57.6% (503/874). The most frequently colonized body sites were oropharyngeal site,account for 35.6% (311/874). The CCI of the nystatin group were lower than those of the control group at T6 and T9 [T6: 0.19±0.10 vs. 0.39±0.15, T9: 0.00 (0.10) vs. 0.45 (0.30), all P<0.05]. The incidence of candidemia in the nystatin group was slightly lower than that in control group [0.5% (3/60) vs. 7.8% (5/64), P>0.05]. The mortality in the nystatin group was lower than that in control group [18.3% (11/60) vs. 34.4% (22/64), P<0.05]. ICU day in the nystatin group was shorter than that in the control group (days: 9.56±3.47 vs. 11.89±6.32, P<0.05). However,hospital day was similar in the two groups (days: 18.35±7.42 vs. 20.58±8.77, P>0.05).. Nystatin might reduce the colonization of Candida albicans and was associated with shorter ICU day.

Topics: Adult; Aged; Candida albicans; Candidemia; Female; Humans; Intensive Care Units; Male; Middle Aged; Mycoses; Nystatin; Prospective Studies; Respiration, Artificial

The aim of this study was to compare the effectiveness of denture microwave disinfection and antifungal therapy on treatment of denture stomatitis.. Sixty denture wearers with denture stomatitis (3 groups; n = 20 each), were treated with nystatin or denture microwave disinfection (1 or 3 times/wk) for 14 days. Mycologic samples from palates and dentures were quantified and identified with the use of Chromagar, and clinical photographs of palates were taken. Microbiologic and clinical data were analyzed with the use of a series of statistical tests (α = .05).. Both treatments similarly reduced clinical signs of denture stomatitis and growth on palates and dentures at days 14 and 30 (P > .05). At sequential appointments, the predominant species (P < .01) isolated was C. albicans (range 98%-53%), followed by C. glabrata (range 22%-12%) and C. tropicalis (range 25%-7%).. Microwave disinfection, at once per week for 2 treatments, was as effective as topical antifungal therapy for treating denture stomatitis.

Topics: Adult; Aged; Analysis of Variance; Antifungal Agents; Chi-Square Distribution; Denture, Complete; Disinfection; Female; Humans; Male; Microwaves; Middle Aged; Mycoses; Nystatin; Oral Hygiene; Smoking; Stomatitis, Denture; Treatment Outcome; Xerostomia

Invasive fungal infections are a major cause of morbidity and mortality in preterm infants. The authors conducted the first prospective, randomised controlled trial of nystatin compared with fluconazole for the prevention of fungal colonisation and invasive fungal infection in very low birth weight (VLBW) neonates.. During a 12-month period, all VLBW neonates were assigned randomly to receive nystatin (1 ml suspension, 100 000 U/ml, every 8 h), fluconazole (3 mg/kg body weight, every third day) or placebo from birth until day 30 of life (day 45 for neonates weighing <1000 g at birth). The authors performed weekly surveillance cultures and systemic fungal susceptibility testing.. During the study period, 278 infants (fluconazole group, n=93; nystatin group, n=94; control group, n=91) weighing <1500 g at birth were admitted. There were no differences in birth weight, gestation, gender or risk factors for fungal infection among the groups. Fungal colonisation occurred in 11.7% of the nystatin group and 10.8% of the fluconazole group, as compared with 42.9% of the control group. The incidence of invasive fungal infection was 4.3% in the nystatin group and 3.2% in the fluconazole group, as compared with 16.5% in the control group. There were no differences in fungal colonisation and invasive fungal infection between the nystatin and fluconazole groups.. Prophylactic nystatin and fluconazole reduce the incidence of colonisation and invasive fungal infection in VLBW neonates. The authors believe that nystatin is an alternative to fluconazole, because nystatin is safe, inexpensive, well tolerated and effective.

Topics: Antifungal Agents; Birth Weight; Disease Progression; Drug Resistance, Fungal; Epidemiologic Methods; Female; Fluconazole; Humans; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases; Infant, Very Low Birth Weight; Male; Microbial Sensitivity Tests; Mycoses; Nystatin; Treatment Outcome

We compared the efficacy and safety of fluconazole and nystatin oral suspensions for the prevention of systemic fungal infection (SFI) in very low birthweight infants. A prospective, randomized clinical trial was conducted over a 15-month period, from May 1997 through September 1998, in 80 preterm infants with birthweights <1500 g. The infants were randomly assigned to receive oral fluconazole or nystatin, beginning within the first week of life. Prophylaxis was continued until full oral feedings were attained. Blood and urine cultures were obtained at enrollment and then weekly thereafter. Thirty-eight infants were randomly assigned to receive oral fluconazole (group I), and 42 infants were assigned to receive nystatin (group II). Birthweight, gestational age, and risk factors for fungal colonization and SFI at the time of randomization and during the hospital course were similar in both groups. SFI developed in two infants (5.3%) in group I and six infants (14.3%) in group II. The difference between these two rates was not statistically significant (relative risk, 0.37; 95% confidence interval, 0.08 to 1.72). There were no deaths in group I and six deaths in group II (P = 0.03). Two infants died of neonatal sepsis, and four deaths were related to necrotizing enterocolitis and/or spontaneous intestinal perforation. No deaths were due to SFI. Enrollment was halted before completion and the study did not attain adequate power to detect a hypothesized drop in SFI rate from 15 to 5%. Although the results cannot justify any conclusion about the relative efficacy of fluconazole versus nystatin in prevention of SFI, the significantly higher mortality rate in the nystatin group raises questions about the relative safety of this medication.

Topics: Administration, Oral; Antifungal Agents; Fluconazole; Humans; Infant, Newborn; Infant, Very Low Birth Weight; Mycoses; Nystatin; Treatment Outcome

The dose-effect relationship of nifuratel (CAS 4936-47-4) + nystatin (CAS 1400-61-9, CAS 34786-70-4) (Macmiror Complex) in topical treatment of vulvo-vaginitis was studied.. Sixty patients with Trichomoniasis and/or Candidiasis were randomized to: 1) nifuratel 125 mg/nystatin 50000 IU, 2) nifuratel 250 mg/nystatin 100000 IU, 3) nifuratel 500 mg/nystatin 200000 IU. Undistinguishable ovules were intravaginally applied qd for 10 days. The dose-effect relationship was assessed by ANCOVA.. After 5 days the microbiological cure rate occurred in 10% of patients in the least dose, in 40% in the middle dose and in 85% in the highest dose group (P = 0.000). After 10 days of treatment, the microbiological cure rate increased to 45%, 84%, and 95%, respectively (P = 0.007). Clinical signs and symptoms gradually disappeared in a dose- and time-dependent manner. No relapse has been observed after 10 day-follow up on 46 patients.. The results confirmed a linear relationship between nifuratel + nystatin dose and effect. The least effective dose was nifuratel 250 mg + nystatin 100,000 IU once daily for 5 days and the best dose in terms of risk/benefit ratio was nifuratel 500 mg + nystatin 200,000 IU once daily for 5 days.

Topics: Adolescent; Adult; Antifungal Agents; Candidiasis, Vulvovaginal; Cross-Over Studies; Dose-Response Relationship, Drug; Double-Blind Method; Drug Combinations; Female; Humans; Middle Aged; Mycoses; Nifuratel; Nystatin; Treatment Outcome; Trichomonas Vaginitis; Vaginal Diseases

Antifungal therapy has been claimed to be effective in polysymptomatic patients with diffuse symptoms from multiple body systems and even well defined diseases, traditionally not related to fungi. Hypersensitivity to fungus proteins and mycotoxins has been proposed as the cause.. We conducted a 4-week randomized, double-blind, placebo-controlled study in 116 individuals selected by a 7-item questionnaire to determine whether the antifungal agent nystatin given orally was superior to placebo. At the onset of the study, the patients were free to select either their regular diet or a sugar- and yeast-free diet, which resulted in four different subgroups: nystatin + diet (ND); placebo + diet (PD); nystatin (N); and placebo (P).. Nystatin was significantly better than placebo in reduction of the overall symptom score (P < 0.003). In six of the 45 individually recorded symptoms, the improvement was significant (P < 0.01). All three active treatment groups reduced their overall symptom scores significantly (P < 0.0001), while the placebo regimen had no effect (P = 0.83). The benefit of diet was significant within both the nystatin (ND > N) and the placebo groups (PD > P).. Nystatin is superior to placebo in reducing localized and systemic symptoms in individuals with presumed fungus hypersensitivity as selected by a 7-item questionnaire. This superiority is probably enhanced even further by a sugar- and yeast-free diet.

Topics: Adult; Aged; Analysis of Variance; Antifungal Agents; Dietary Sucrose; Double-Blind Method; Family Practice; Fatigue; Female; Female Urogenital Diseases; Gastrointestinal Diseases; Humans; Male; Male Urogenital Diseases; Medical History Taking; Memory Disorders; Middle Aged; Multiple Carboxylase Deficiency; Mycoses; Nystatin; Pain; Respiratory Tract Diseases; Skin Diseases; Surveys and Questionnaires; Treatment Outcome

The efficacy and safety of itraconazole oral solution and a combination of amphotericin B capsules plus nystatin oral suspension were compared in the prophylaxis of fungal infections in neutropenic patients. In an open, randomized, multicentre trial, 144 patients received itraconazole oral solution 100 mg bd, and 133 patients received amphotericin B 500 mg tds plus nystatin 2 MU qds. Overall, 65% of itraconazole-treated patients were considered to have had successful prophylaxis, compared with 53% in the polyene group. Proven deep fungal infections occurred in 5% of patients in each group. Fewer patients receiving itraconazole than amphotericin plus nystatin had superficial infections (3 versus 8%; P = 0.066). This trend in favour of itraconazole was seen in patients with profound neutropenia (neutrophil count <0.1 x 10(9) cells/L at least once) or prolonged neutropenia (neutrophil count <1.0 x 10(9) cells/L for >14 days). The median time to prophylactic failure was longer in the itraconazole group (37 days) than in the polyene group (34 days). The number of patients with fungal colonization (nose, sputum, stool) changed more favourably from baseline to endpoint in the itraconazole group than in the polyene group. Both treatments were safe and well tolerated; however, patients receiving amphotericin plus nystatin had a higher incidence of nausea and rash. In conclusion, itraconazole oral solution at doses of 100 mg bd and oral amphotericin B plus nystatin have similar prophylactic efficacy against fungal infections in neutropenic patients. On the basis of reduced incidence of superficial fungal infections, fungal colonization and specific adverse events, itraconazole may be the preferred treatment.

Topics: Adult; Aged; Amphotericin B; Antifungal Agents; Female; Humans; Itraconazole; Male; Middle Aged; Mycoses; Neoplasms; Neutropenia; Nystatin

Nonabsorbable antibiotics for selective bowel decontamination (SBD) sometimes are administered to liver transplant patients to prevent postoperative infections, but the efficacy of SBD is not known. Accordingly, we prospectively studied 69 patients randomly assigned to receive conventional prophylaxis with systemic antibiotics (control patients) or conventional prophylaxis plus oral nonabsorbable antibiotics for SBD (SBD patients). Overall rates of bacterial and/or yeast infections were nearly equal among control patients (42%) and SBD patients (39%). However, the infection rate at SBD key sites (abdomen, bloodstream, surgical wound, and lungs) was lower among patients who received the SBD regimen > or = 3 days before transplantation (23%) than among control patients (36%). Administration of the SBD regimen was complicated by gastrointestinal intolerance and noncompliance but not by increased stool colonization with antibiotic-resistant gram-negative bacilli. Practical problems associated with administering an SBD regimen to patients awaiting cadaver liver transplants limit the regimen's usefulness, but we found a trend toward reduced key site infection when the regimen was given > or = 3 days before transplantation.

Topics: Ampicillin; Anti-Bacterial Agents; Antibiotic Prophylaxis; Bacterial Infections; Cefotaxime; Colistin; Drug Administration Schedule; Evaluation Studies as Topic; Feces; Female; Gentamicins; Humans; Intestines; Liver Transplantation; Male; Mycoses; Nystatin; Risk Factors; Treatment Outcome

The goal of this prospective randomized single-center study was the comparison of safety and efficacy of high-dose oral/intravenous fluconazole (400 mg daily) (group A) with oral nystatin plus miconazole inhalations (group B) in the prevention of fungal infections on a hemato-oncological isolation Ward. Of 157 patients admitted to the isolation ward during the study period only 90 (57%) were eligible for randomization; 22 (14%) had a fungal infection at admission. Of the 90 randomized patients, 89 were evaluable, 43 in group A and 46 in group B. The age, sex, diagnosis, planned therapy and risk factors for fungal infections at admission as well as the duration of neutropenia were in the same proportions in both groups. Oral thrush and mucocutaneous candidiasis were prevented in all patients of both groups, and 29 patients (32%: 17 in group A, 12 in group B) were discharged after successful prophylaxis (NS). Empiric amphotericin B was given according to predetermined criteria to 45 patients (51%: 23 group A, 22 group B; NS). Fluconazole significantly delayed the time before the start of intravenous amphotericin B. It was begun after a median of 10 days (0-45 days, range) of neutropenia below 0.5 x 10(9) granulocytes/l in group A and 7.5 days (0-26, range) in group B (P < 0.05). The duration of successful prophylaxis was significantly longer in group A (26 days median) than in group B (21 days, median) (P < 0.05). Systematic fungal infection was documented in 3 patients (1 group A, 2 group B; NS).

Topics: Adolescent; Adult; Aged; Female; Fluconazole; Humans; Immunocompromised Host; Male; Miconazole; Middle Aged; Mycoses; Neutropenia; Nystatin; Prospective Studies

A randomized, comparative study was conducted in 502 patients in 23 centres world-wide to assess the efficacy and safety of fluconazole versus nystatin and amphotericin B for prevention of fungal infection in a severely immunocompromised pediatric population. Patients scheduled within 48 hours to undergo chemotherapy or radiotherapy for hematological or oncological malignancies were randomly allocated to receive 3 mg/kg oral fluconazole once daily, 50,000 U/kg oral nystatin four times daily or 25 mg/kg oral amphotericin B four times daily. Prophylaxis began with the initiation of chemotherapy or radiotherapy and continued throughout a patient's hospital stay or period of neutropenia as necessary. The mean duration of fluconazole prophylaxis was 27.8 days and of the oral polyenes 29.2 days. The outcome of prophylaxis with fluconazole was significantly superior to that with the polyenes (p = 0.01). Mycologically verified infections occurred in 5 patients (2.1%) given fluconazole and in 21 (8.4%) given polyenes (p = 0.002). Clinical evaluation at the end of prophylaxis showed that the clinical outcome was definitely or possibly successful in 87% in the fluconazole group and 82% in the polyenes group with no significant differences between the treatment groups. Mycological evaluation demonstrated reduction or control of colonization in 84% in the fluconazole group and 85% in the polyenes group, again with no significant between-group differences. Possibly drug-related side effects, mainly mild to moderate gastrointestinal disturbances, were reported in 38 patients given fluconazole, with eight subsequent withdrawals, and in 21 patients given oral polyenes, with three subsequent withdrawals. Laboratory test abnormalities occurred in 28 patients given fluconazole and 24 given polyenes.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Administration, Oral; Adolescent; Amphotericin B; Candida; Child; Child, Preschool; Female; Fluconazole; Hematologic Diseases; Humans; Immunocompromised Host; Infant; Infant, Newborn; Male; Mycoses; Neoplasms; Nystatin

Topics: Adolescent; Adult; Aged; Antilymphocyte Serum; Cyclosporine; Cytomegalovirus Infections; Drug Therapy, Combination; Female; Graft Rejection; Humans; Immunosuppression Therapy; Incidence; Liver Transplantation; Male; Methylprednisolone; Middle Aged; Muromonab-CD3; Mycoses; Nystatin; Prospective Studies; Transplantation, Homologous

An open, randomized study was performed at 18 European centres to compare the efficacy, safety and tolerance of oral fluconazole with oral polyenes for the prophylaxis of fungal colonization and infection in adults at high risk of developing neutropenia. Five hundred and thirty-six hospitalized patients with malignant disease, about to receive chemotherapy, radiotherapy, or bone marrow transplantation, and who were already neutropenic or were expected to develop neutropenia were included in the study. Before therapy or transplantation, patients commenced either oral fluconazole therapy (50 mg/day as a single dose) or oral polyenes therapy (amphotericin B 2 g/day and/or nystatin 4 x 10(6) units/day in four or more divided doses), for a mean of 29.3 days and 31.3 days, respectively. After baseline clinical and mycological testing, patients were re-evaluated at least weekly during prophylaxis, at the end of prophylaxis and two to six weeks later to identify proven or suspected fungal infection and to determine rates of colonization with fungi. Fungal infection was diagnosed in 41 of 511 evaluable patients, 10 (3.9%) of 256 in the fluconazole group and 31 (12.2%) of 255 in the polyene group (P = 0.001). This total included four patients (1.6%) in the fluconazole group who developed oropharyngeal candidiasis compared with 22 (8.6%) in the polyene group (P < 0.001). Systemic infections comprised 6 (2.3%) in the fluconazole group and 9 (3.5%) in the polyene group (P = not significant), and included three Candida krusei infections in each group. Parenteral amphotericin B therapy was given empirically for persistent fevers in an additional 62 (24.2%) patients receiving fluconazole and 59 (23.1%) receiving polyenes (P = not significant). Colonization with fungi was generally similar in each treatment group, although an increased proportion of patients receiving fluconazole developed colonization of the faeces (P < 0.01). Adverse reactions, possibly related to treatment, were recorded in 15 (5.6%) of 269 patients in the fluconazole group and 14 (5.2%) of 267 in the polyene group; these necessitated discontinuation of therapy in seven patients in each group. Once-a-day fluconazole was therefore more effective than oral polyenes for the prevention of oropharyngeal fungal infection and as effective for the prevention of infections at other sites in patients with neutropenia.

Topics: Administration, Oral; Adolescent; Adult; Aged; Aged, 80 and over; Amphotericin B; Child; Female; Fluconazole; Humans; Male; Middle Aged; Mycoses; Neutropenia; Nystatin

Prevention of systemic fungal infection in the very-low-birthweight infant is important since it is associated with a high morbidity and mortality. To determine if oral nystatin administration could prevent fungal colonization and infection, we evaluated 67 preterm infants with birthweights less than 1250 gm. Thirty-three infants received 1 ml (100,000 units/ml) of nystatin inside the mouth every 8 hours until 1 week after extubation. Oropharyngeal, rectal, blood, and urine cultures were obtained on the 1st day of life and weekly. Endotracheal cultures were obtained three times a week from intubated infants. Four (12%) of the 33 nystatin-treated infants had positive cultures, two (6%) developed systemic infection. The control group consisted of 34 infants, 15 (44%) had positive fungal cultures and 11 (32%) developed systemic infection. Fungi isolated were Candida species and Torulopsis glabrata. Colonized infants were dependent on the respirator (P less than 0.001), had indwelling catheters (P less than 0.01), and received antibiotics (P less than 0.05) for a longer period than infants free from fungi and their mortality was significantly higher (P less than 0.05). We conclude that prophylactic administration of oral nystatin reduces fungal colonization and infection in very-low-birthweight infants.

Topics: Administration, Oral; Clinical Trials as Topic; Humans; Infant, Low Birth Weight; Infant, Newborn; Mycoses; Nystatin; Random Allocation; Time Factors

We evaluated the efficacy and toxicity of ketoconazole versus nystatin antimycotic prophylaxis in a prospective randomized study of 32 patients receiving intensive weekly outpatient combination chemotherapy for non-Hodgkin's lymphoma with crossover to the other drug if failure occurred. Thirteen patients were assigned to nystatin and 19 to ketoconazole. Fungal infections occurred in three patients receiving nystatin (16%) and one patient receiving ketoconazole (8%); one patient refused his assigned drug due to taste intolerance. Including the crossover courses of drug, the failure rate associated with ketoconazole was 6% while that for nystatin was 20% (p = 0.23). We favor ketoconazole as antifungal prophylaxis during antilymphoma chemotherapy because of at least equivalent and possibly superior efficacy, better acceptance by patients, easier administration, and systemic absorption.

Topics: Aged; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Clinical Trials as Topic; Cyclophosphamide; Doxorubicin; Female; Humans; Ketoconazole; Leucovorin; Lymphoma, Non-Hodgkin; Male; Methotrexate; Middle Aged; Mycoses; Nystatin; Prednisone; Prospective Studies; Random Allocation; Time Factors; Vincristine

Topics: Adult; Clinical Trials as Topic; Female; Humans; Miconazole; Middle Aged; Mycoses; Nystatin; Random Allocation; Vaginitis

In a randomized trial we compared ketoconazole (400 mg once daily, 27 patients) and nystatin (3 X 10(6) units four times daily, 29 patients) for prevention of fungal infection in neutropenic patients undergoing marrow transplantation in a protective environment. Fewer weekly surveillance cultures contained Candida species in ketoconazole recipients than in nystatin recipients (70 [26%] of 274 vs. 151 [47%] of 322; P less than .001). When all fungi were considered, the difference in colonization was less but was still significant (117 [43%] of 274 vs. 173 [54%] of 322; P = .01), primarily due to increased colonization of the rectum with Torulopsis glabrata among ketoconazole recipients (P less than .001). No difference in the incidence of local mucosal infection was seen. Two disseminated fungal infections occurred, both in nystatin recipients. Compliance with ketoconazole was significantly better than was compliance with nystatin (96% vs. 68%; P less than .001), but similar effects on colonization were found in an analysis adjusting for compliance. Ketoconazole was better tolerated and more effective than nystatin in reducing colonization due to Candida species but was also associated with significantly increased rates of colonization with T. glabrata.

Topics: Agranulocytosis; Candida albicans; Candidiasis; Clinical Trials as Topic; Environment, Controlled; Humans; Ketoconazole; Mycoses; Neutropenia; Nystatin; Patient Compliance; Random Allocation

A prospective randomized study was undertaken in neutropenic patients to evaluate the efficacy of prophylactic ketoconazole v nystatin in reducing yeast infections. Eighteen patients received 500,000 units of nystatin suspension four times daily, and 18 patients received 200 mg of ketoconazole daily. The nystatin group experienced nine local yeast infections (four thrush, three esophagitis, and two vaginitis); three patients receiving ketoconazole had thrush. No cases of disseminated candidiasis occurred in either group. Ketoconazole was better tolerated than nystatin and neither drug caused toxic effects. In addition to being nontoxic and better tolerated, ketoconazole appeared to be slightly more effective than nystatin in reducing locally severe yeast infections.

Topics: Adult; Agranulocytosis; Female; Humans; Ketoconazole; Male; Middle Aged; Mycoses; Neutropenia; Nystatin; Prospective Studies; Random Allocation

As invasive fungal infection remains a common problem in the management of cancer patients, chemoprophylaxis of these opportunistic infections is desperately needed. The most frequently investigated antifungal agents have been nystatin, amphotericin B, and ketoconazole. In placebo-controlled studies, high doses of antifungal agents decreased the positive results from surveillance cultures, and there is some suggestion that such chemoprophylaxis may reduce the incidence of invasive candidiasis in neutropenic cancer patients. However, no oral chemoprophylaxis has effectively prevented aspergillosis or mucormycoses in these patients. There are still many areas of controversy, and the most adequate regimens, if any, remain to be defined.

Topics: Administration, Oral; Administration, Topical; Amphotericin B; Antifungal Agents; Candidiasis; Clinical Trials as Topic; Humans; Ketoconazole; Miconazole; Mycoses; Neoplasms; Nystatin

Topics: Adolescent; Adult; Clinical Trials as Topic; Humans; Ketoconazole; Leukemia; Lymphoma; Mycoses; Nystatin; Oropharynx; Species Specificity; Yeasts

The clinical and microbiologic efficacy of trimethoprim alone and trimethoprim/sulfamethoxazole for infection prevention was evaluated in 75 patients during 92 episodes of granulocytopenia. Ultimately, 60 patients were evaluable during 77 episodes of granulocytopenia, 36 episodes in the trimethoprim group and 41 episodes in the trimethoprim/sulfamethoxazole group. The incidence of infection was higher in the trimethoprim group (50 percent) than in the trimethoprim/sulfamethoxazole group (39 percent), but this did not reach statistical significance. Trimethoprim did not appear to be as protective as trimethoprim/sulfamethoxazole when the granulocyte count was less than 100/mm3. In patients receiving trimethoprim/sulfamethoxazole, aerobic gram-negative bacilli cleared from fecal surveillance cultures more often and new aerobic gram-negative bacilli were acquired less often than in those receiving trimethoprim alone (p less than 0.05). More myelosuppression was observed among patients receiving trimethoprim/sulfamethoxazole (p less than 0.001). These observations suggest that trimethoprim alone may not be optimal for preventing colonization and infection in granulocytopenic patients and that combination with other agents may be necessary to increase the spectrum of activity. Trimethoprim/sulfamethoxazole itself may predispose toward an increased risk of infection by prolonging myelosuppression.

Topics: Adult; Agranulocytosis; Bacteria; Bacterial Infections; Clinical Trials as Topic; Drug Combinations; Feces; Female; Humans; Male; Mycoses; Nystatin; Premedication; Sulfamethoxazole; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination

Sixty-two profoundly granulocytopenic patients with acute leukemia undergoing induction chemotherapy were prospectively randomized to receive either trimethoprim-sulfamethoxazole plus nystatin or nalidixic acid plus nystatin for prevention of infection. Patients given trimethoprim-sulfamethoxazole plus nystatin during initial remission induction experienced an increased duration (22.6 vs. 13.6 days) of profound granulocytopenia (less than 100 granulocytes/mm3; P = 0.007). Acquisition of gram-negative bacilli was more frequent among patients treated with nalidixic acid plus nystatin while filamentous fungi were acquired more frequently by patients receiving trimethoprim-sulfamethoxazole plus nystatin (P = 0.05). The median duration of on-study time prior to documentation of first infection was longer for patients receiving trimethoprim-sulfamethoxazole plus nystatin (17 days) than for those receiving nalidixic acid plus nystatin (eight days) (P = 0.0002). Three infection-related deaths occurred among patients receiving nalidixic acid; seven occurred among patients receiving trimethoprim-sulfamethoxazole, five of which were secondary to pneumonia due to Aspergillus flavus. Both of these methods of selective antimicrobial modulation have apparent advantages, but each has disadvantages serious enough to limit their routine use.

Topics: Adolescent; Adult; Aged; Agranulocytosis; Bacterial Infections; Child; Drug Combinations; Female; Humans; Leukemia; Male; Middle Aged; Mycoses; Nalidixic Acid; Nystatin; Patient Compliance; Prospective Studies; Random Allocation; Sulfamethizole; Sulfathiazoles; Trimethoprim

72 patients severely immunocompromised by their underlying disease (marrow aplasia, acute leukaemia, or solid tumour) or by the treatment they were receiving, or both, were randomised to receive antifungal prophylaxis with either oral ketoconazole or conventional doses of oral amphotericin B and nystatin. All patients also had gut decontamination with non-absorbable antibiotics, skin antisepsis, sterile food, and oral cotrimoxazole. Protection against fungal infection was significantly superior with ketaconazole. When patients who had received allogeneic bone-marrow transplant were studied separately, there was no significant difference between the two treatments, probably because there was a fall-off in ketoconazole absorption from the end of the third week after the transplant. However, ketoconazole greatly reduced the likelihood of fungal infection in non-transplant patients.

Topics: Amphotericin B; Clinical Trials as Topic; Drug Therapy, Combination; Humans; Imidazoles; Immunosuppressive Agents; Ketoconazole; Leukemia; Mycoses; Neutropenia; Nystatin; Piperazines; Random Allocation

The relationship between vaginal pH, microflora, and yeast infection was investigated in 93 women randomly treated with either nystatin or miconazole pessaries and cream for two weeks. The vaginal pH was measured in a control group of 48 women. In the study group, 37 patients defaulted, 39 were cured, and 17 required treatment during the six-month follow-up period. In both study and control groups before and after treatment the mean vaginal pH was in the range of 4.3-4.6. Lactobacilli were plentiful in 78 (91%) out of 86 patients and shows that lactobacilli and yeasts commonly coexist. The influence of other organisms appeared to be negligible. The trial showed that nystatin and micromazole were equallly effective in the treatment of vaginal yeast infection and that the broad-spectrum activity of micronazole offered no advantage in this condition.

Topics: Adolescent; Adult; Female; Humans; Hydrogen-Ion Concentration; Lactobacillus; Menstruation; Miconazole; Middle Aged; Mycoses; Nystatin; Vagina; Vaginitis; Yeasts

The past 40 years have brought great advances in the knowledge of morphology, immunology and epidemiology of fungal infections in man. Each general advance in the science of medicine has had its counterpart in man's improved facility to deal with these infections therapeutically. Although satisfactory control of fungal infections of man is still lacking, productive paths of investigation seem to have been found and the continued application of rigorous discipline to research efforts should provide even more efficient treatment in the future.

Topics: Amphotericin B; Antifungal Agents; Blastomycosis; Clinical Trials as Topic; Flucytosine; History, 18th Century; History, 19th Century; History, 20th Century; Humans; Mycoses; Nystatin; Stilbamidines; United States

Topics: Candida albicans; Cytosine; Drug Evaluation; Female; Flucytosine; Humans; Mycoses; Nystatin; Vaginal Diseases

Topics: Antifungal Agents; Clinical Trials as Topic; Female; Humans; Hydrogen-Ion Concentration; Metronidazole; Mycoses; Natamycin; Nystatin; Trichomonas Vaginitis; Vaginitis

Topics: Clinical Trials as Topic; Female; Gastrointestinal Diseases; Humans; Male; Mycoses; Nystatin; Respiratory Tract Infections; Tetracycline; Urinary Tract Infections; Yeasts

Antifungal polyene macrolide antibiotics Amphotericin B (AmB) and Nystatin (NYS) were conjugated through the ω-amino acid linkers with diwalled "molecular umbrellas" composed of spermidine-linked deoxycholic or cholic acids. The presence of "umbrella" substituents modulated biological properties of the antibiotics, especially their selective toxicity. Some of the AmB-umbrella conjugates demonstrated antifungal in vitro activity comparable to that of the mother antibiotic but diminished mammalian toxicity, especially the hemolytic activity. In contrast, antifungal in vitro activity of NYS-umbrella conjugates was strongly reduced and all these conjugates demonstrated poorer than NYS selective toxicity. No correlation between the aggregation state and hemolytic activity of the novel conjugates was found.

Topics: Amphotericin B; Antifungal Agents; Fungi; HEK293 Cells; Hemolysis; Hep G2 Cells; Humans; Mycoses; Nystatin; Polyenes

Several polyene macrolides are potent antifungal agents that have severe side effects. Increased glycosylation of these compounds can improve water solubility and reduce toxicity. Three extending glycosyltransferases are known to add hexoses to the mycosaminyl sugar residues of polyenes. The Actinoplanes caeruleus PegA enzyme catalyses attachment of a D-mannosyl residue in a β-1,4 linkage to the mycosamine of the aromatic heptaene 67-121A to form 67-121C. NppY from Pseudonocardia autotrophica adds an N-acetyl-D-glucosamine to the mycosamine of 10-deoxynystatin. NypY from Pseudonocardia sp. P1 adds an extra hexose to a nystatin, but the identity of the sugar is unknown. Here, we express the nypY gene in Streptomyces nodosus amphL and show that NypY modifies 8-deoxyamphotericins more efficiently than C-8 hydroxylated forms. The modified heptaene was purified and shown to be mannosyl-8-deoxyamphotericin B. This had the same antifungal activity as amphotericin B but was slightly less haemolytic. Chemical modification of this new disaccharide polyene could give better antifungal antibiotics.

Topics: Acetylglucosamine; Actinobacteria; Amphotericin B; Antifungal Agents; Candida albicans; Glycosyltransferases; Hexosamines; Leishmania; Leishmaniasis; Macrolides; Mycoses; Nystatin; Streptomyces

A series of novel morpholinoquinoline based conjugates with pyrazoline moiety were synthesized under microwave irradiation. The newly synthesized compounds were screened for their preliminary in vitro antibacterial activity against a panel of pathogenic strains of bacteria and fungi, antituberculosis activity against Mycobacterium tuberculosis H37Rv and antimalarial activity against Plasmodium falciparum. Most of them exhibited significant antibacterial activity as compared to the first line drugs. Compounds 6a and 9d were found to possess excellent antibacterial activity potency as compared to ampicillin (286 μM), chloramphenicol (154 μM) and ciprofloxacin (150 μM). In antifungal screening, against Candida albicans, compounds 6c, 7c, 8a, 8b, 8c and 9b showed significant activity as compared to griseofulvin (1147 μM). Compounds 8b, 6b, 9d, 6a, 9b, 7b and 8a displayed brilliant activity against P. falciparum strain as compared to chloroquine (IC50 0.062 μM) as well as quinine (IC50 0.826 μM). Compounds 6d, 7b, 8b, 9c and 9d exhibited superior antitubercular activity. Among them 8b was found to be equipotent to rifampicin with 95% inhibition. The cytotoxicity of the synthesized compounds was tested using bioassay of Schizosaccharomyces pombe cells at cellular level.

Topics: Anti-Infective Agents; Antimalarials; Antitubercular Agents; Bacteria; Bacterial Infections; Fungi; Humans; Malaria, Falciparum; Microbial Sensitivity Tests; Mycobacterium tuberculosis; Mycoses; Plasmodium falciparum; Pyrazoles; Quinolines; Structure-Activity Relationship; Tuberculosis

Idiopathic pulmonary fibrosis (IPF) is a progressive and fatal lung disease with limited response to currently available therapies. Alveolar type II (ATII) cells act as progenitor cells in the adult lung, contributing to alveolar repair during pulmonary injury. However, in IPF, ATII cells die and are replaced by fibroblasts and myofibroblasts. In previous preclinical studies, we demonstrated that ATII-cell intratracheal transplantation was able to reduce pulmonary fibrosis. The main objective of this study was to investigate the safety and tolerability of ATII-cell intratracheal transplantation in patients with IPF.. We enrolled 16 patients with moderate and progressive IPF who underwent ATII-cell intratracheal transplantation through fiberoptic bronchoscopy. We evaluated the safety and tolerability of ATII-cell transplantation by assessing the emergent adverse side effects that appeared within 12 months. Moreover, pulmonary function, respiratory symptoms, and disease extent during 12 months of follow-up were evaluated.. No significant adverse events were associated with the ATII-cell intratracheal transplantation. After 12 months of follow-up, there was no deterioration in pulmonary function, respiratory symptoms, or disease extent.. Our results support the hypothesis that ATII-cell intratracheal transplantation is safe and well tolerated in patients with IPF. This study opens the door to designing a clinical trial to elucidate the potential beneficial effects of ATII-cell therapy in IPF.

Topics: Adrenal Cortex Hormones; Aged; Alveolar Epithelial Cells; Anti-Infective Agents; Bacterial Infections; Bronchoscopy; Cell Transplantation; Disease Progression; Female; Forced Expiratory Volume; Ganciclovir; Graft Rejection; Humans; Idiopathic Pulmonary Fibrosis; Immunosuppressive Agents; Leucovorin; Male; Middle Aged; Mycophenolic Acid; Mycoses; Nystatin; Pulmonary Diffusing Capacity; Tacrolimus; Trachea; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination; Valganciclovir; Virus Diseases; Vital Capacity; Walk Test

A new series of fluorinated pyrazoles, 4a-e, were synthesized in good to excellent overall yields (65-82%) from the corresponding chalcones, 3a-e, by ultrasonic irradiation. The newly synthesized compounds were characterized and screened for their in vitro anti-bacterial, anti-fungal, and anti-tubercular activities against Mycobacterium tuberculosis H(37)Rv.

Topics: Anti-Infective Agents; Antitubercular Agents; Bacteria; Bacterial Infections; Fungi; Green Chemistry Technology; Halogenation; Humans; Microbial Sensitivity Tests; Mycobacterium tuberculosis; Mycoses; Pyrazoles; Tuberculosis

Yeasts occur as part of the normal human microbiota. Nevertheless, some species are opportunistic, affecting immunocompromised patients such as those undergoing oncologic treatment.. To detect the presence of yeasts in patients suffering from head and neck cancer who are receiving radiation therapy and display lesions in the oral cavity, compatible with candidiasis; and to evaluate the antifungal susceptibility of the isolates recovered.. Sixty samples from patients were obtained by swabbing the oral mucosa. Identification of isolates were performed by classical taxonomic, morphological and biochemical methods as well as by using commercial identification kits. Susceptibility to antifungal drugs was determined by the agar diffusion method with Neosensitabs(®) disks.. Forty-six samples (77%) yielded positive findings, and species recovered were: Candida albicans (22 isolates), Candida tropicalis (13 isolates), Candida parapsilosis (six strains), Candida krusei (three strains), Candida dubliniensis and Saccharomyces cerevisiae (one each). All strains were susceptible to itraconazole, clotrimazole, voriconazole, nystatin and amphotericin B. On the other hand, 65% of strains were miconazole-susceptible while 35%, showed intermediate susceptibility. With regard to ketoconazole, only three strains (7%) corresponding to C. albicans (one isolate) and C. krusei (two isolates) displayed intermediate susceptibility. Only C. krusei strains were resistant to fluconazole while all the other species were susceptible. Eventually, only six isolates (13%) were susceptible to terbinafine while the remaining strains were resistant in vitro.. Early detection of etiological agents causing lesions, as well as the evaluation of their susceptibility to commonly used drugs, are crucial in order to choose the appropriate treatment that will minimize complications while improving the quality of patients' lives.

Topics: Amphotericin B; Antifungal Agents; Candidiasis, Oral; Drug Resistance, Fungal; Head and Neck Neoplasms; Humans; Microbial Sensitivity Tests; Mycoses; Naphthalenes; Nystatin; Opportunistic Infections; Saccharomyces cerevisiae; Species Specificity; Terbinafine; Triazoles

A new series of fused pyran derivatives 5a-x bearing 2-morpholinoquinoline nucleus has been synthesized under microwave irradiation by a reaction of 2-morpholinoquinoline-3-carbaldehyde 2a-c, malononitrile 3 and compounds 4a-h in presence of NaOH as basic catalyst. All the compounds were screened against three Gram positive bacteria (Streptococcus pneumoniae, Clostridium tetani, Bacillus subtilis), three Gram negative bacteria (Salmonella typhi, Vibrio cholerae, Escherichia coli) and two fungi (Aspergillus fumigatus, Candida albicans) using broth microdilution MIC (Minimum Inhibitory Concentration) method. Of the compounds studied, compounds 5b, 5f, 5k, 5m, 5q, 5s and 5v have found to be most efficient members of the series.

Topics: Anti-Bacterial Agents; Anti-Infective Agents; Bacteria; Candida albicans; Fungi; Gram-Negative Bacteria; Gram-Negative Bacterial Infections; Gram-Positive Bacteria; Gram-Positive Bacterial Infections; Humans; Microbial Sensitivity Tests; Microwaves; Mycoses; Pyrans; Quinolines

1,4-Naphthoquinones are unique reagents in organic synthesis and have been employed in several well known and recently developed areas of application. Furthermore, these 1,4-naphthoquinones have demonstrated high reactivity in nucleophilic vinylic substitutions, in the preparation of sulfurated, (hetero)cyclic and several other transformations. This study describes the synthesis and biological evaluation of derivatives of monosulfurated naphthalene-1,4-dione (3), 3-chloro-2-ethoxy-naphthalene-1,4-dione (4), disulfurated naphthalene-1,4-dione (5), and symmetrical bis-1,4-naphthoquinones (7, 9) were obtained from the reaction of 2,3-dichloro-naphthaquinone (1) with S-, O-substituted mono-, di-, and tetrathiols, respectively. The structures of the novel products were characterized by spectroscopic methods.

Topics: Anti-Bacterial Agents; Anti-Infective Agents; Antifungal Agents; Bacteria; Bacterial Infections; Fungi; Humans; Microbial Sensitivity Tests; Mycoses; Naphthoquinones; Nitrogen; Sulfur Compounds

Paecilomyces lilacinus causes multiple diseases in humans, especially in immunocompromised patients. Cutaneous infections are the second most commonly encountered circumstance. We describe a woman with liver cirrhosis with hemorrhagic, bullous, ulcerative leg lesions caused by Paecilomyces lilacinus. The lesions improved after treatment with oral voriconazole and topical nystatin powder. We also reviewed previously reported cases of cutaneous P. lilacinus infection that were treated by oral voriconazole.

Topics: Administration, Oral; Administration, Topical; Aged; Antifungal Agents; Dermatomycoses; Female; Humans; Liver Cirrhosis; Mycoses; Nystatin; Paecilomyces; Pyrimidines; Skin Ulcer; Treatment Outcome; Triazoles; Voriconazole

This is the first report documenting the presence of a high number of Cyniclomyces guttulatus yeasts in the faeces of a cat. The animal was initially presented with acute complaints of vomiting and diarrhoea. The patient responded well to oral salazosul-fapyridine but the stools remained soft and C. guttulatus yeasts were still present. After a course of nystatin (15,000 IU/kg bw q24 PO for 4 days) the stools were normal and no yeasts were found anymore (centrifugation/flotation/zinc sulphate). C. guttulatus occurs naturally in the digestive tract of rabbits, guinea pigs, chinchillas, rats and mice. It is occasionally found in massive numbers in the faeces of dogs with diarrhoea; part of these patients respond well to nystatin treatment. Recent experience indicates that the most effective dosage of nystatin for dogs and cats is 50.000 IU/kg q24 PO for 4 days.

Topics: Animals; Antifungal Agents; Cat Diseases; Cats; Diarrhea; Feces; Female; Mycoses; Nystatin; Saccharomycopsis; Sulfasalazine; Treatment Outcome

Topics: Administration, Oral; Amoxicillin; Anti-Bacterial Agents; Antifungal Agents; Drug Eruptions; Drug Hypersensitivity; Erythema; Female; Humans; Lung Neoplasms; Male; Middle Aged; Mycoses; Nystatin; Opportunistic Infections; Patch Tests; Time Factors; Tooth Diseases; Withholding Treatment

Topics: Animals; Antifungal Agents; Diarrhea; Feces; Female; Mycoses; Nystatin; Rabbits; Saccharomycetales

To report otomycosis in a retrospective study and correlate clinical, epidemiological and therapeutic factors.. This study comprises 97 cases of clinically and mycologically proven otomycosis or fungal otitis externa gathered during a 12-year period.. Most cases were unilateral (90.7%) and the main predisposing factors associated with the disease were trauma (secondary to the constant scratching) and the use of topical antibiotics. Major causal agents were several species of Aspergillus (63.9%), of which Aspergillus flavus was commonest (26%), followed by Candida albicans (26.8%) and Aspergillus niger (21%).. The treatment of choice is mainly local toilet of the external auditory canal and the use of systemic antifungal agents to prevent re-infection and the spread of disease.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Antifungal Agents; Aspergillosis; Aspergillus flavus; Aspergillus niger; Child; Ear Diseases; Female; Humans; Male; Merbromin; Middle Aged; Mycoses; Nystatin; Retrospective Studies

The post-antifungal effect (PAFE) of amphotericin B and nystatin against 30 clinical zygomycetes was evaluated using two different media. PAFE is a suppression of fungal growth after limited drug exposure. The MICs of both drugs were determined using NCCLS M38-P guidelines. A spectrophotometric method was used to determine PAFE in vitro. Spores were exposed to amphotericin B and nystatin in RPMI-1640 or AM3 at concentrations of 4 x and 1 x MIC for 4 h for Absidia sp. and at 1 x and 0.5 x MIC for 1 h for the other strains. Drugs were eliminated by washing. Exposed and control spores were cultured in microtitre wells and incubated for 48 h. PAFE was calculated as T - C (Delta t) between the control and the exposure fungi. The first increase in optical density (OD0) was used to calculate PAFE and was considered significant when the value of the lower 95%CI of the exposed strain was greater than the upper 95%CI of the control. MIC ranges in RPMI-1640 were: 0.06-4 mg/L for amphotericin B and 0.5-8 mg/L for nystatin; MIC ranges in AM3 were: 0.06-2 mg/L for amphotericin B and 0.5-4 mg/L for nystatin. Killing was not observed at the concentration and exposure time used. In RPMI-1640, for amphotericin B the rank order for PAFE was Absidia corymbifera (5.6 h) > Rhizopus oryzae (5.2 h) > Mucor spp. (3.5 h) > Rhizopus microsporus (3 h), and for nystatin the rank order was Mucor spp. (5.8 h) > R. oryzae (3.3 h) > A. corymbifera (2.9 h) > R. microsporus (1.7 h). PAFE was not induced in Rhizomucor spp. PAFE was dependent on drug concentration.

Topics: Amphotericin B; Antifungal Agents; Culture Media; Fungi; Microbial Sensitivity Tests; Mycoses; Nystatin; Spores, Fungal

Topics: Administration, Oral; Antifungal Agents; Candida; Fluconazole; Humans; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases; Mycoses; Nystatin

Topics: Amphotericin B; Antifungal Agents; Drug Combinations; Humans; Lipids; Mycoses; Nystatin; Phosphatidylcholines; Phosphatidylglycerols

Topics: Amphotericin B; Antifungal Agents; Candicidin; Candida; Fluconazole; Humans; Itraconazole; Miconazole; Mycoses; Nystatin

In a prospective study, 132 patients were investigated for yeast infection of burn wounds. Ten patients (7.6%) were infected with Candida species. All patients with yeast infections were also infected with bacteria with the exception of one patient who was infected with Candida tropicalis alone. The predominant yeast recovered was Candida krusei. Yeast infection was found to be more common in the younger age group. The isolation of a Candida species alone from one patient and Candida isolation from patients with sepsis in burn wounds indicate a significant role for yeasts in the production of infection in burn wounds. Therefore, special cultures for yeasts are recommended for all cases of burn wound infection.

Topics: Administration, Topical; Adolescent; Adult; Aged; Antifungal Agents; Burns; Candidiasis; Child; Child, Preschool; Female; Humans; Infant; Male; Middle Aged; Mycoses; Nystatin; Prevalence; Prospective Studies

Topics: Amphotericin B; Animals; Antifungal Agents; Aspergillosis; Candidiasis; Fluconazole; Humans; Immunocompromised Host; Itraconazole; Mycoses; Nystatin; Pyrimidines; Triazoles; Voriconazole

Topics: Antifungal Agents; Humans; Liposomes; Microbial Sensitivity Tests; Mitosporic Fungi; Mycoses; Nystatin; Opportunistic Infections

Angioinvasive fungal infections have a significant morbidity and mortality in the immunocompromised host. Massive burns produce a profound derangement in cellular immunity along with a loss of cutaneous barrier function. Treatment of fungal burn wound infections poses a difficult therapeutic challenge. We present a new method of treatment for angioinvasive fungal infections with nystatin powder at a concentration of 6,000,000 units/g. It proved to be efficacious in four consecutive severely burned patients affected by massive angioinvasive fungal infection. Both superficial and deep tissue infections were eradicated without any other therapeutic interventions or adverse effects on wound healing.

Topics: Administration, Topical; Antifungal Agents; Aspergillus; Biopsy; Burns; Child; Drug Therapy, Combination; Fusarium; Humans; Itraconazole; Mycoses; Nystatin; Powders; Retrospective Studies; Skin Transplantation; Trauma Severity Indices; Treatment Outcome; Wound Healing; Wound Infection

Topics: Animals; Antifungal Agents; Candidiasis; Drugs, Investigational; HIV Infections; Humans; Mice; Mycoses; Nystatin

Meta-analyses may become biased if the reported data in the individual trials are biased and if overlap among trials cannot be identified. We describe the unanticipated problems we encountered in collecting data for a meta-analysis comparing a new antifungal agent, fluconazole, with amphotericin B in patients with cancer complicated by neutropenia. In 3 large trials that comprised 43% of the patients identified for the meta-analysis, results for amphotericin B were combined with results for nystatin in a "polyene" group. Because nystatin is recognized as an ineffective drug in these circumstances, this approach creates a bias in favor of fluconazole. Furthermore, 79% of the patients were randomized to receive oral amphotericin B, which is poorly absorbed and not an established treatment, in contrast to intravenous amphotericin B, which was administered in 4 of 5 placebo-controlled trials, or 86% of patients. It was unclear whether there was overlap among the "polyene" trials, and it is possible that results from single-center trials were included in multicenter trial reports. We were unable to obtain information to clarify these issues from the trial authors or the manufacturer of fluconazole. Two of 11 responding authors replied that the data were with the drug manufacturer and two indicated that they did not have access to their data because of change of affiliation. In the meta-analyses, fluconazole and amphotericin B (mostly given orally) had similar effects (13 trials), whereas nystatin was no better than placebo (3 trials). Since individual trials are rarely conclusive, investigators, institutions, and pharmaceutical companies should provide essential details about their work to ensure that meta-analyses can accurately reflect the studies conducted and that patients will realize maximum benefits from treatments. We recommend that investigators keep copies of their trial data to help facilitate accurate and unbiased meta-analyses.

Topics: Amphotericin B; Antifungal Agents; Fluconazole; Humans; Meta-Analysis as Topic; Mycoses; Neoplasms; Neutropenia; Nystatin; Opportunistic Infections; Publication Bias; Randomized Controlled Trials as Topic; Research Design

Invasive fungal infections (IFI) are one of the most important causes of mortality in liver transplant (LT) recipients. The aim of this study was to describe the characteristics of IFI in the LT program of our institution with an special emphasis in the differences between Candida infections (CI) and that caused by other fungi (NCI).. Retrospective analysis of the hospital charts of 21 patients who underwent a LT from February 1987 to December 1995. The diagnosis of IFI required the histological evidence of tissue invasion or a positive culture in a tissue sample or in an usually sterile fluid. Esophageal candidiasis was not considered as IFI. Antifungal prophylaxis was performed either with nystatin or fluconazole.. Twenty-one of 356 patients (6%) developed a total of 23 episodes of IFI. Pathogens were Candida spp. (n = 10), Aspergillus (n = 8), Zygomicetes (n = 4) and Cryptococcus (n = 1). Fifty-seven percent of the episodes of IFI (80% of those caused by Candida and 38% of those produced by other fungi; p < 0.05) developed in the first 3 months after transplantation and only 5 episodes appeared after the sixth month. The diagnosis of IFI was done at autopsy in 6 patients (29%). Overall, NCI (13 episodes) predominated over CI (10 episodes), being the later the cause of the 54% of the episodes in the first 178 recipients but only the 30% in the last 178 patients (p = 0.09). No differences were found in the distribution of the risk factors amongst those patients with CI or NCI. Seventeen of the 21 patients (71%) died and 15 of these deaths (72%) were attributable to fungi; 15 patients who died either did not receive amphotericin (n = 6) or received a cumulative dose lower than 500 mg. Six patients received a cumulative dose of more than 1.5 g (mean, 3.2 g) and four of them were cured. Mortality in the nonfungal infection group was 26% (p < 0.001).. IFI was a rare but severe complication in our LT recipients. The relative frequency of CI was progressively decreasing during the study period, being NCI the predominant infections. Amphotericin therapy was effective only when a high cumulative dose could be administered.

Topics: Adult; Amphotericin B; Antifungal Agents; Female; Fluconazole; Humans; Liver Transplantation; Male; Middle Aged; Mycoses; Nystatin; Retrospective Studies; Severity of Illness Index

The Blom-Singer tracheoesophageal voice prosthesis has undergone continuous design modifications during the last 18 years to make it more effective, anatomically compatible, and easier to use. This evolution continues with the recent introduction of an indwelling-style voice prosthesis intended for use by individuals who are unable or disinclined to use a self-removable-style voice prosthesis. The a priori self-lifespan goal of the indwelling prosthesis was 180 days.. The present investigation describes the experience of 81 consecutive participants who used a total of 206 indwelling voice prosthesis. Selection criteria included total laryngectomy and either primary (n = 35) or secondary (n = 46) tracheoesophageal puncture. All participants had external-beam radiotherapy either pre- or postlaryngectomy. Specifically, lifespan of the prosthesis, the effects and clinical management of fungal colonization, and participant satisfaction with this style prosthesis were studied.. A prosthesis use rate of 90% was observed. Group 1 prostheses (without fungal colonization and without Nystatin therapy) exhibited a lifespan significantly longer than did group 2 prostheses (with fungal colonization and prior to Nystatin therapy) (sample mean [mean] = 185.6 days versus 80.6 days; p < .05). Group 3 prostheses (following Nystatin therapy) also exhibited a lifespan significantly longer than that of group 2 prostheses (mean = 156.1 days versus 80.6 days; p < .05). Lifespans of group 1 and group 3 prostheses were not significantly different (p < .05).. The extended-wear, indwelling voice prosthesis achieved its a priori lifespan goal of 180 days (6 months) with almost uniform patient preference and without risk of increased complications. When fungal colonization was present. Nystatin therapy significantly prolonged prosthesis lifespan.

Topics: Adult; Aged; Aged, 80 and over; Analysis of Variance; Antifungal Agents; Esophagostomy; Female; Granulation Tissue; Humans; Laryngectomy; Larynx, Artificial; Male; Middle Aged; Mycoses; Nystatin; Patient Satisfaction; Patient Selection; Prosthesis Design; Prosthesis Failure; Prosthesis-Related Infections; Radiotherapy; Time Factors; Trachea; Tracheostomy; Voice

Topics: Adolescent; Adult; Ampicillin; Analysis of Variance; Anti-Bacterial Agents; Antibiotic Prophylaxis; Antifungal Agents; Bacterial Infections; Ceftriaxone; Cefuroxime; Child; Child, Preschool; Feces; Graft Rejection; Humans; Infant; Liver Transplantation; Middle Aged; Mycoses; Nystatin; Postoperative Complications; Regression Analysis; Retrospective Studies; Risk Factors; Tobramycin

Topics: Animals; Bacteria, Aerobic; Bacterial Infections; Colistin; Drug Therapy, Combination; Enterobacteriaceae; Female; Intestine, Small; Liver; Liver Transplantation; Lung; Lymph Nodes; Mycoses; Nystatin; Postoperative Complications; Spleen; Swine; Tobramycin; Transplantation, Autologous; Vancomycin

To evaluate the use of antifungal agents in hospitalized patients prior to marketing of fluconazole and to assess characteristics associated with their use.. A cohort of hospitalized patients receiving topical or systemic antifungal therapy was monitored concurrently.. Sixty-nine hospitals ranging in size from 100 to more than 500 beds, 70.1 percent affiliated with medical schools.. Participating clinical pharmacists each identified 15 consecutive patients receiving systemic antifungal therapy and 5 consecutive patients receiving topical antifungal therapy at their institutions. Data collection began October 1989 and ended March 1990.. All data collected were observational in nature, and no patient intervention was required.. Characteristics of patients receiving antifungal therapy were compared using t-tests and chi-square tests. Utilization and patterns of use of antifungal therapy were reported.. The most common risk factors necessitating antifungal therapy, in descending order, were: administration of broad-spectrum antibiotics and/or presence of invasive catheters, carcinoma, AIDS, leukemia or lymphoma, diabetes mellitus, solid organ or bone marrow transplantation, and chronic obstructive pulmonary disease. Five hundred seventeen patients received systemic therapy and 464 (89.7 percent) received a single systemic agent. Of these, 242 (52.2 percent) received amphotericin B, 215 (46.3 percent) received ketoconazole, 6 (1.3 percent) received flucytosine, and 1 (0.2 percent) received intravenous miconazole. Fifty-three patients received two systemic agents either concurrently or consecutively. Ketoconazole was most often used for presumed or documented oral, urogenital, or esophageal infections and amphotericin B was the preferred agent for disseminated infections and fungemia (p < 0.001). Almost half of the patients receiving amphotericin B or ketoconazole (48.3 percent) received these drugs as empiric therapy. Documented infections were more likely to be treated with amphotericin B (54.8 percent) than with ketoconazole (27.4 percent) (p < 0.001). The predominant fungal isolates were Candida albicans, Candida spp., and unspecified yeasts. Amphotericin B toxicity led to discontinuation of drug therapy in only 5.1 percent of cases. Two hundred sixty-nine patients (34.2 percent) received topical antifungal therapy only. Nystatin oral suspension was prescribed to 65.3 percent of the patients, clotrimazole troches to 23.0 percent, amphotericin B irrigation to 10.9 percent, and nystatin tablets to 0.8 percent.. The utilization patterns of antifungal agents in this survey follow established therapeutic guidelines. Prior to the introduction of fluconazole, amphotericin B was the agent of choice for documented systemic fungal infections. Ketoconazole was more often used for prophylaxis of fungal infections and treatment of oral and esophageal infections.

Topics: AIDS-Related Opportunistic Infections; Amphotericin B; Antifungal Agents; Drug Utilization; Hospitals; Humans; Ketoconazole; Mycoses; Nystatin; Prospective Studies; Risk Factors; United States

In a non-randomized study the efficacy of itraconazole in preventing fungal infections in neutropenic patients was investigated. Forty-seven patients with acute leukemia or advanced lymphoblastic lymphoma were enrolled. Ninety-two episodes of severe neutropenia after chemotherapy were observed. Mean duration of neutropenia was 24 days. Norfloxacin was administered as prophylaxis against gram-negative infections and itraconazole 200 mg b.i.d. as antifungal prophylaxis. Surveillance cultures of throat, urine, feces and vagina or prepuce were performed regularly. Four patients died, two patients due to heart failure, two patients due to staphylococcal pneumonia. Only in one case Candida albicans was cultured from bronchoalveolar lavage fluid. No systemic mycosis or Aspergillus fumigatus pneumonia was documented. In a similar group of patients treated in the preceding 18 months nystatin was used as antifungal prophylaxis. In this group of patients six cases of Aspergillus fumigatus pneumonia, two cases of Candida albicans fungemia and one case of Candida glabrata pneumonia occurred of which six patients died. Itraconazole seems to be effective in preventing fungal infections in neutropenic patients and is well tolerated.

Topics: Adolescent; Adult; Aged; Antifungal Agents; Female; Humans; Itraconazole; Ketoconazole; Male; Middle Aged; Mycoses; Neutropenia; Nystatin; Prospective Studies

For prevention of infection we used an SD design including antibacterial (trimethoprim 480 mg/daily, sulfamerazine 720 mg/daily, and polymyxin 0.25 mg/daily) and antifungal (4-6 million IU nystatin/daily) components. We analyzed retrospectively 138 treatment periods in 108 patients. The intensified chemotherapy resulted in severe granulocytopenia below 0.1 x 10(9)/liter over 25.2 days. In 19 patients there was suspicion of major fungal infection; therefore they were given amphotericin B and 5-fluocytosine. Fourteen of them died; major fungal infections were documented in 5 cases. In 18% of all the deceased we found major fungal infections. There was a correlation between fungal infection, the late stages of the hematological malignancy, and the lesions on the oropharyngeal mucosa. However, in terms of the serological and culture findings no correlation appeared to exist between the group with and the group without fungal infection. The SD regime is meant to suppress the Candida cell concentration in the digestive tract but has no influence on Aspergillus in the respiratory tract.

Topics: Acute Disease; Adolescent; Adult; Aged; Bacterial Infections; Digestive System; Drug Administration Schedule; Drug Therapy, Combination; Female; Humans; Leukemia; Male; Middle Aged; Mycoses; Nystatin; Opportunistic Infections; Polymyxins; Sulfamerazine; Trimethoprim

Topics: Candida; Candidiasis; Culture Media; Humans; In Vitro Techniques; Mitosporic Fungi; Mycoses; Nystatin; Polyenes; Recurrence; Rhodotorula

Two groups of immunocompromised patients were studied with the aim of pointing out the possibilities of antifungal prophylaxis in this type of patient. All patients received oral treatment with nystatin, but only the patients of one group were also in strict reverse isolation. It has been confirmed that chemoprophylactic treatments may control opportunistic endogenous mycoses effectually. On the contrary, only reverse isolation seems to be effective against airborne exogenous fungal infections. Because of the difficulty and high cost of this practice, different modalities for a really generalizable antifungal prophylaxis are required. At present only the detection of new systemic antifungal drugs, which are not toxic and are easy to use, seems hopeful.

Topics: Fungi; Humans; Immune Tolerance; Mycoses; Nystatin; Opportunistic Infections; Patient Isolation

From our clinical trials of different available antifungal drugs for the cases of keratomycosis, we conclude that Econazole 1% ointment is a safe and effective antifungal agent having a wide range of antifungal activity. With rising incidence of mycotic ulcer particularly in rural population where facilities for laboratory diagnosis and drug sensitivity tests for antifungal drugs are lacking Econazole can be useful as a broad spectrum antifungal agent for the cases of keratomycosis and also could be used as a prophylactic in cases of traumatic corneal ulcer as those are particularly at risk.

Topics: Amphotericin B; Antifungal Agents; Corneal Ulcer; Econazole; Humans; Mycoses; Nystatin; Ointments

Topics: Ear Diseases; Ethylmercury Compounds; Humans; Mouth Diseases; Mycoses; Nystatin; Thimerosal

Selective antimicrobial decontamination with norfloxacin was compared with vancomycin/polymyxin for prophylaxis of bacterial infections in granulocytopenic patients. In the group of patients receiving norfloxacin, there were a lower number of acquired gram-negative bacillary organisms per patient (0.88 versus 1.86, p = 0.002), fewer patients with documented infection (16 of 36 versus 20 of 30, p = 0.12), and fewer cases of gram-negative septicemia (0 of 36 versus five of 30, p = 0.02). Norfloxacin was better tolerated (30 of 36 versus 16 of 30 patients highly compliant, p = 0.02), and associated with fewer gastrointestinal side effects (eight of 36 versus 14 of 36 patients, p = 0.07). These results suggest that norfloxacin is a more tolerable and efficacious oral antimicrobial agent than vancomycin/polymyxin for the prevention of serious gram-negative bacillary infections in granulocytopenic patients.

Topics: Adolescent; Adult; Aged; Agranulocytosis; Bacterial Infections; Drug Evaluation; Drug Tolerance; Female; Gram-Negative Bacteria; Gram-Positive Bacteria; Humans; Male; Middle Aged; Mycoses; Norfloxacin; Nystatin; Polymyxins; Vancomycin

A mycotic keratitis case which was caused by Curvularia lunata var. aeria in a patient with an injury in the eye is described. The diagnosis was based on the mycologic analysis of several samples taken from the ulcer of cornea. In vitro tests of the sensitivity of the isolated species to several antifungal drugs were made. The results were related to the response in vivo to the treatment.

Topics: Aged; Cornea; Eye Injuries; Humans; Keratitis; Male; Miconazole; Mitosporic Fungi; Mycoses; Natamycin; Nystatin

Topics: Adult; Agranulocytosis; Anti-Infective Agents; Bacterial Infections; Digestive System; Humans; Mycoses; Nalidixic Acid; Neutropenia; Nystatin

Infection in the granulocytopenic patient is often life-threatening, and the frequency and severity of infection are increased regardless of the cause of leukocyte suppression. Trimethoprim-sulfamethoxazole plus nystatin is known to be effective in preventing colonization and infection by the primary pathogens responsible for the morbidity and mortality associated with granulocytopenia. When treating granulocytopenic patients, clinicians should use proper barrier techniques to minimize nosocomial colonization. When foci of oral infection are present or bacteremia is predictable, appropriate antibiotics should be prescribed.

Topics: Agranulocytosis; Anti-Bacterial Agents; Bacterial Infections; Dental Care for Disabled; Humans; Mouth Diseases; Mycoses; Nystatin; Premedication; Sepsis; Sulfamethoxazole; Trimethoprim; Virus Diseases

Nystatin, one million units every four hours, was prospectively studied as a prophylactic antifungal agent in 164 neutropenic patients who were not initially colonized by fungi: 104 received nystatin and 60 served as controls. Fungal colonization occurred in 68/104 (65%) nystatin recipients and in 43/60 (71%) controls. However, nystatin significantly reduced multiple body site colonization and persistent oropharyngeal colonization. Despite these alterations in colonization profile, 16/104 (15%) nystatin recipients developed disseminated fungal infections, as compared to 5/60 (8%) control patients (0.5 greater than p greater than 0.1, N.S). Differences in the clinical course of colonized and non-colonized patients were observed. Eighteen of 111 (16%) colonized patients had afebrile clinical courses as compared to 16/53 (30%) non-colonized patients (p less than 0.05). Twenty-nine of 93 (31%) febrile episodes in colonized patients failed to respond to empiric antibiotic therapy as compared to 3/37 (8%) episodes in non-colonized patients (p less than 0.01). Disseminated fungal infections were diagnosed in 19/111 (17%) of colonized patients, as compared to 1/53 (2%) non-colonized patients (p less than 0.02). We conclude that colonized patients are more likely to develop febrile clinical courses, to fail to respond to empiric antibiotic therapy, and to develop disseminated fungal infection. Nystatin altered colonization patterns but did not prevent disseminated fungal infection.

Topics: Adolescent; Adult; Aged; Agranulocytosis; Anti-Bacterial Agents; Drug Combinations; Female; Fever; Humans; Male; Middle Aged; Mycoses; Nystatin; Oropharynx; Prospective Studies; Random Allocation; Sulfamethoxazole; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination; Yeasts

Records of 65 surgical patients with positive fungal blood cultures were reviewed to address risk, overall mortality, and treatment. Negative urine cultures did not rule out sepsis. Staphylococcus epidermidis sepsis was present in 27 (42%) of the patients. In 70% of whom it occurred before or during fungemia. Increased mortality correlated with the use of multiple antibiotics, antibiotic use for prolonged periods, and with associated bacterial sepsis. Stopping antibiotic therapy did not reduce mortality. Amphotericin B reduced mortality in patients with dissemination, indicating that it is the treatment of choice for disseminated fungemia and that antibiotic therapy should not be discontinued when concomitant bacterial sepsis is present.

Topics: Adolescent; Adult; Aged; Amphotericin B; Anti-Bacterial Agents; Blood; Child; Child, Preschool; Female; Fungi; Humans; Infant; Male; Middle Aged; Mycoses; Nystatin; Postoperative Complications; Staphylococcal Infections

Topics: Adult; Amphotericin B; Antifungal Agents; Child; Dermatomycoses; Female; Griseofulvin; Humans; Male; Mycoses; Nystatin; Pyrrolidinones

Topics: Candidiasis; Humans; Imidazoles; Immunity; Ketoconazole; Miconazole; Mycoses; Neoplasms; Nystatin; Piperazines

Topics: Adult; Aminoglycosides; Amoxicillin; Amphotericin B; Ampicillin; Anti-Bacterial Agents; Bacterial Infections; Cephalosporins; Cytarabine; Dental Care; Doxycycline; Drug Interactions; Humans; Idoxuridine; Mycoses; Nystatin; Penicillins; Tetracyclines; Virus Diseases

Topics: Amphotericin B; Antifungal Agents; Corneal Ulcer; Humans; Miconazole; Mycoses; Nystatin

Topics: Child; Humans; Leukemia; Mycoses; Neoplasms; Nystatin

The type of fungal infection and the immunologic status of the patient determine whether drug therapy should be used. Amphotericin B is the single most important antifungal agent for the treatment of systemic mycoses. Flucytosine is given adjunctively with amphotericin B. Miconazole, a new parenteral agent, may be useful in treating candidiasis, cryptococcosis, paracoccidioidomycosis and coccidioidomycosis. Potassium iodide is used to treat lymphocutaneous sporotrichosis, bronchopulmonary geotrichosis and chromoblastomycosis. Nystatin, tolnaftate, clotrimazole and haloprogin are used for mucocutaneous infections. Griseofulvin is limited to the treatment of skin and nail infections caused by dermatophytes.

Topics: Adult; Amphotericin B; Antifungal Agents; Child; Flucytosine; Griseofulvin; Humans; Miconazole; Mycoses; Nystatin; Potassium Iodide; Stilbamidines; Tolnaftate

Nystatin G has proved to be an excellent antimycotic in suppository form, its concentration of active principle being 200,000 I.U. Mycoses were brought under complete control in 88 per cent of 75 patients by one single cycle of treatment, during which one suppository was inserted daily over ten consecutive days. Primary therapy failed in twelve per cent. Most of those patients had been using hormonal contraceptives over many years or were pregnant. Full therapeutic effect, basically, depends on successful treatment of the rectum on treatment of the partner.

Topics: Candida; Candidiasis, Vulvovaginal; Female; Humans; Mycoses; Nystatin; Pregnancy; Pregnancy Complications, Infectious; Vaginal Diseases

The therapeutic effectiveness of poliene antibiotics, such as nystatin, polyfungin, and pimafucin, was comparatively analysed in the context of mycoses of the genital organs of girls in various periods of development. Early detection of fungi in genital organs, the oral cavity, rectum, and urethra is of great importance to mycosis treatment of children. Whenever antimycotic treatment is followed by recurrent outbreaks, all persons in the child's closer environment have to be examined at any rate.

Topics: Adolescent; Anal Canal; Child; Child, Preschool; Female; Genital Diseases, Female; Humans; Infant; Male; Mouth; Mycoses; Natamycin; Nystatin; Polyenes; Urethra; Vagina; Vulvovaginitis

Several manifestations of equine corenal ulcers caused by mycotic agents are discussed. Antifungal therapy is reviewed. Mycotic keratitis should be suspected when routine corneal ulcer therapy is nonproductive.

Topics: Amphotericin B; Animals; Clotrimazole; Horse Diseases; Horses; Keratitis; Mycoses; Natamycin; Nystatin

Severe mixed infection was observed in 9 out of 101 renal transplant recipients over a period of 6 years and was characterized by the simultaneous incidence of bacterial, fungal and viral infections. Severe septicaemia was clinically evident in all cases. The critical clinical situation called for a rapid assessment of the differential diagnosis and relevant bacterial, fungal and viral investigations. Antibacterial and antimycotic therapy must be instituted as soon as possible on account of the high mortality from mixed infection in renal transplant recipients. The reduction or discontinuation of immunosuppressive therapy during infection did not impair renal transplant function.

Topics: Bacterial Infections; Female; Gentamicins; Humans; Immunosuppression Therapy; Kidney Transplantation; Male; Miconazole; Mycoses; Nystatin; Transplantation, Homologous; Virus Diseases

Topics: Antifungal Agents; Bacteria; Candida; Candida albicans; Candidiasis, Vulvovaginal; Clotrimazole; Female; Humans; Imidazoles; Miconazole; Mycoses; Nystatin; Vagina; Vaginitis

The author presents the drugs that are available for the treatment of opportunistic mycoses: amphotericin B, nystatin, 5-fluorocytosine, miconazole and the newest imidazole derivative econazole. He presents his experience with econazole in 4 cases with deep mycoses. He speaks of the mode of application and the therapeutical limits of these products as well as of the favorable factors and the prophylactic measures to be taken.

Topics: Adult; Amphotericin B; Antifungal Agents; Drug Evaluation; Econazole; Flucytosine; Humans; Miconazole; Mycoses; Nystatin

Infections of children with malignant disease, especially of the lympho-reticular system, are characterized by their severity, with a high mortality, as a consequence of defective immunocompetence. According to the immunosurveillance theory, temporary immune defects could have even facilitated the malignant growth. The neoplastic disease itself contributes to the immunodeficiency by multiple mechanisms. The powerful cytostatic-cytocidal drugs reduce the immune response also, especially in the phases of bone marrow depression. Granulocytopenia shows the most significant correlation with the incidence of serious infections. The different forms of hospital infections have been reviewed and classified as 1. bacterial, fungal and, rarely, (but most dangerous) protozoal infections, 2. endogenous infections with the patient's own anaerobic intestinal flora and 3. viral infections. The perspectives of up-to-date chemotherapy and management of the immunodeficiency e.g. with leucocyte transfusions, and attempts to prevent infection are discussed.

Topics: Amphotericin B; Antineoplastic Agents; Bacterial Infections; Blood Transfusion; Child; Communicable Diseases; Cross Infection; Humans; Immunologic Surveillance; Immunosuppression Therapy; Leukocytes; Leukopenia; Miconazole; Mycoplasma Infections; Mycoses; Neoplasms; Nutrition Disorders; Nystatin; Patient Isolation; Protozoan Infections; Tetracyclines; Virus Diseases

The new therapeutic methods based on antibiotics, corticosteroids and immunosuppressors and the new medicosurgical techniques (catheters, monitoring in intensive-care units, open-heart surgery) modify the host, favorise the adaptation and introduction f endogenous and exogenous yeast-like fungi and thus create a new pathology characterized by deep visceral or septicemic infections due to yeasts belonging to the genera Candida, Torulopsis, Cryptococcus, Trichosporon, Rhodotorula, and Saccharomyces. The pathological aspects are analyzed and therapy is suggested in the light of new findings on polyenes (nystatine, amphotericine B), 5-fluorocytosine, imidazole, derivatives (miconazole, econazole) considering their association in function of synergy or antagonism possibilities.

Topics: Amphotericin B; Candida; Candidiasis; Cryptococcosis; Dermatomycoses; Endocarditis; Flucytosine; Humans; Iatrogenic Disease; Imidazoles; Lung Diseases, Fungal; Mycoses; Nystatin; Osteitis; Sepsis; Urinary Tract Infections

Topics: Amphotericin B; Flucytosine; Humans; Mycoses; Natamycin; Nystatin; Serologic Tests; Skin Tests; Specimen Handling; Sputum

Topics: Adolescent; Adult; Child; Drug Combinations; Drug Evaluation; Female; Genital Diseases, Female; Humans; Mycoses; Neomycin; Nystatin; Polymyxin B; Pregnancy

Topics: Adult; Breast Diseases; Breast Feeding; Female; Humans; Mycoses; Nystatin

Topics: Aged; Eye Diseases; Eye Foreign Bodies; Humans; Male; Mycoses; Nystatin

Topics: Amphotericin B; Ampicillin; Aspergillus fumigatus; Bacterial Infections; Erythromycin; Humans; Mycoses; Nystatin; Penicillin Resistance; Sinusitis; Tetracycline; Trimethoprim

When there is a suspicion of the presence of a mycosis an exact diagnosis is necessary. Apart from the qualitative and quantitative culture to this also belongs an analysis of mycological kinds and a testing of the resistance against antimycotic drugs. The culture of primarily resistant yeast strains and the observation of a change of the mycological causative organisms render this demand urgent.

Topics: Antifungal Agents; Candidiasis, Oral; Drug Resistance, Microbial; Humans; Miconazole; Mycoses; Nystatin

Therapeutic failure in vaginitis can be minimized if all cases are properly diagnosed and specific therapy is given. Use of wet mounts combined with liberal use of cultures, especially for Corynebacterium vaginale, should result in an accurate diagnosis in over 90% of cases. Treatment of choice for candidiasis is nystatin or miconazole nitrate applied topically. For trichomoniasis, metronidazole should be given orally to both sexual partners. Ampicillin, cephalexin, or cephradine are recommended for C vaginale infection.

Topics: Ampicillin; Candidiasis, Vulvovaginal; Contraception; Corynebacterium Infections; Female; Humans; Metronidazole; Miconazole; Mycoses; Nystatin; Sexual Behavior; Trichomonas Vaginitis; Vaginitis

Topics: Amphotericin B; Antifungal Agents; Child; Clotrimazole; Drug Resistance; Flucytosine; Griseofulvin; Humans; Immunologic Deficiency Syndromes; Miconazole; Mycoses; Nystatin

Topics: Child; Child, Preschool; Cytosine; Drug Evaluation; Female; Flucytosine; Humans; Infant; Infant, Newborn; Male; Mycoses; Nystatin

A number of antibiotics having an antimycotic action are reviewed. The physicochemical and pharmacotoxicological properties, antifungal range, mechanisms of action, dosage and preparations of griseofulvin, amphotericin-B, natamycin, nystatin and pecilocin are discussed.

Topics: Amphotericin B; Antifungal Agents; Candida; Griseofulvin; Microsporum; Mycoses; Natamycin; Nystatin; Streptomyces; Trichophyton

Uremia is defined as the accumulation of nitrogenous waste products in the blood. Uremia may be caused by either acute or chronic renal failure. Uremic stomatitis represents a relatively uncommon intraoral complication of uremia. Uremic stomatitis has classically been divided into ulcerative and nonulcerative types. Reported here is a patient with chronic renal failure exhibiting intraoral lesions that persisted despite local treatment but rapidly cleared following renal dialysis. This case represents the first published report of the microscopic appearance of the nonulcerative type and presents unusual tissue changes heretofore unreported.

Topics: Adult; Biopsy; Candidiasis, Oral; Coloring Agents; Diagnosis, Differential; Dihydroxyphenylalanine; Humans; Hydrogen Peroxide; Male; Mycoses; Nystatin; Renal Dialysis; Stomatitis; Tetracycline; Uremia

A 36-year-old female was admitted to hospital for debridement of chronically inflamed tendon sheaths and adjacent tissues near the left ankle. Despite antibiotic therapy and initial surgical interventions, the inflammation had progressed slowly over 16 months. Histopathological examination of excised tissues in September 1973 revealed a chronic granulomatous inflammation of tendon sheaths and muscle. Many branched hyphal segments, intercalary swollen cells, and a few conidia-like bodies were seen in sections, and also in KOH- and PAS-stained slides prepared from homogenized tissues. Culture of homogenized tissues yielded pure colonies of Scopulariopsis brevicaulis. Sensitivity tests were initially begun with amphotericin B, potassium iodide, and potassium tartrate (0.05-15 mug/ml of the phytone-yeast extract agar), and no inhibitory effect was observed. Subsequently, amphotericin B, antimony, 5-fluorocytosine (5-FC), griseofulvin, hamycin, and mycostatin were tested (25-300 mug/ml of the phytone-yeast extract agar). Of these chemicals, griseofulvin and hamycin proved to be most effective. Antimony and 5-FC were ineffective, and mycostatin produced a negligible effect on growth. The four strains of Lysobacter antibioticus, the producer of myxin antibiotic, strongly inhibited the growth of the fungus.

Topics: Adult; Amphotericin B; Ankle Joint; Antimony; Chronic Disease; Female; Flucytosine; Granulation Tissue; Griseofulvin; Humans; Microbial Sensitivity Tests; Mitosporic Fungi; Mycoses; Natamycin; Nystatin; Potassium Iodide; Staining and Labeling; Tartrates; Tendinopathy

Topics: Adolescent; Adult; Air Movements; Amphotericin B; Anti-Bacterial Agents; Antifungal Agents; Bacterial Infections; Bacteriuria; Child; Ear; Feces; Female; Gentamicins; Humans; Male; Middle Aged; Mycoses; Nose; Nystatin; Paromomycin; Patient Isolators; Pharynx; Polymyxins; Skin; Vagina; Vancomycin

Topics: Amphotericin B; Animals; Antifungal Agents; Aspergillus; Drug Resistance, Microbial; Fungi; Gentian Violet; Mucor; Mycoses; Nystatin; Poultry; Poultry Diseases; Respiratory System; Rhizopus; Sulfonamides

Topics: Adult; Aged; Candidiasis, Oral; Denture, Complete; Female; Humans; Middle Aged; Mouth Diseases; Mycoses; Nystatin; Stomatitis, Denture

Topics: Aged; Candida; Candida albicans; Female; Humans; Male; Mycoses; Nystatin; Tongue Diseases

Topics: Capsules; Female; Gastrointestinal Diseases; Humans; Lung Diseases, Fungal; Male; Mouth Diseases; Mycoses; Nystatin; Urogenital System

Topics: Amphotericin B; Animals; Mice; Mycoses; Nystatin; Phialophora; Taiwan

Topics: Amphotericin B; Animals; Aspergillosis; Candidiasis; Eye Diseases; Humans; Keratitis; Mycoses; Natamycin; Nystatin; Rabbits

Topics: Adrenal Cortex Hormones; Antifungal Agents; Benzene Derivatives; Cytosine; Drug-Related Side Effects and Adverse Reactions; Fluorine; Gentian Violet; Histoplasmosis; Humans; Iatrogenic Disease; Imidazoles; Immunosuppressive Agents; Mycoses; Natamycin; Nystatin; Sulfonamides

Topics: Amphotericin B; Antifungal Agents; Cornea; Corneal Transplantation; Curettage; Eye Diseases; Fungi; Humans; Methods; Mycoses; Natamycin; Nystatin

Topics: Acute Disease; Administration, Oral; Adolescent; Adult; Aged; Agranulocytosis; Anti-Bacterial Agents; Bacterial Infections; Feces; Female; Gentamicins; Humans; Leukemia; Male; Middle Aged; Mycoses; Neutrophils; Nystatin; Remission, Spontaneous; Vancomycin

Topics: Amphotericin B; Antifungal Agents; Aspergillosis; Blastomycosis; Candidiasis; Coccidioidomycosis; Cryptococcosis; Flucytosine; Histoplasmosis; Humans; Iodides; Mycoses; Nystatin; Sporotrichosis

Topics: Agranulocytosis; Amphotericin B; Antineoplastic Agents; Aspergillosis; Candidiasis; Cryptococcosis; Cytosine; Diabetes Complications; Glucocorticoids; Humans; Immunosuppression Therapy; Mucormycosis; Mycoses; Nystatin

Topics: Amphotericin B; Anti-Infective Agents; Antifungal Agents; Bacterial Infections; Child; Drug Therapy, Combination; Griseofulvin; Humans; Iodides; Mycoses; Nystatin; Streptomycin; Sulfamethoxazole; Sulfonamides; Tetracycline; Tolnaftate; Trimethoprim; Vancomycin

Topics: Amphotericin B; Antifungal Agents; Dermatomycoses; Griseofulvin; Humans; Mycoses; Nystatin; Penicillins; Potassium Iodide; Stilbamidines; Sulfonamides

Topics: Amphotericin B; Basidiomycota; Humans; Mycoses; Nystatin; Potassium Iodide

Topics: Adult; Amphotericin B; Antilymphocyte Serum; Azathioprine; Dactinomycin; Female; Heart Transplantation; Humans; Infections; Male; Middle Aged; Mycoses; Nystatin; Prednisone; Propylene Glycols; Protozoan Infections; Respiratory Tract Infections; Sepsis; Staphylococcal Infections; Transplantation Immunology; Transplantation, Homologous; Urinary Tract Infections; Virus Diseases

Topics: Acremonium; Adult; Amphotericin B; Aspergillosis; Candidiasis; Conjunctiva; Cornea; Corneal Transplantation; Corneal Ulcer; Curettage; Eye Diseases; Eye Injuries; Female; Fusarium; Humans; Male; Mycoses; Nystatin; Potassium Iodide

Topics: Aged; Candidiasis; Diagnosis, Differential; Diagnostic Errors; Geotrichosis; Humans; Lung Diseases, Fungal; Lung Neoplasms; Male; Mycoses; Nystatin

Topics: Amphotericin B; Antifungal Agents; Griseofulvin; Humans; Mycoses; Nystatin

Topics: Adult; Aged; Amphotericin B; Biopsy; Diabetes Complications; Diabetic Ketoacidosis; Ethmoid Bone; Eye Diseases; Female; Fungi; Humans; Infant; Male; Maxillary Sinus; Middle Aged; Mycoses; Nystatin; Orbit; Sphenoid Bone

Topics: Amphotericin B; Humans; Mycoses; Nystatin

Topics: Amphotericin B; Antifungal Agents; Corneal Ulcer; Humans; Mycoses; Nystatin

Topics: Child; Child, Preschool; Female; Genital Diseases, Female; Humans; Infant; Mycoses; Nystatin

Topics: Amphotericin B; Anti-Bacterial Agents; Candida; Candidiasis; Cornea; Cortisone; Culture Media; Eye Diseases; Germany, West; Griseofulvin; Humans; Male; Mycoses; Nystatin

Topics: Adult; Aged; Amphotericin B; Anti-Bacterial Agents; Candida; Child; Cornea; Cortisone; Eye Diseases; Female; Griseofulvin; Humans; Keratitis; Male; Middle Aged; Mycoses; Nystatin

Topics: Amphotericin B; Chronic Disease; Contact Lenses; Corneal Transplantation; Corneal Ulcer; Epithelium; Female; Humans; Idoxuridine; Keratitis, Dendritic; Keratoconjunctivitis; Male; Middle Aged; Mycoses; Nystatin; Sjogren's Syndrome; Transplantation, Homologous

Topics: Amphotericin B; Antifungal Agents; Griseofulvin; Humans; Mycoses; Natamycin; Nystatin; Ointments

Topics: Actinomycosis; Amphotericin B; Animals; Antifungal Agents; Atropine; Chorioretinitis; Conjunctivitis; Eye Diseases; Hot Temperature; Humans; Laser Therapy; Light Coagulation; Mycoses; Natamycin; Nocardia Infections; Nystatin; Penicillins; Rabbits; Sporotrichosis; Streptomycin; Sulfacetamide; Sulfadiazine; Vitreous Body

Topics: Amphotericin B; Animals; Antifungal Agents; Aspergillus; Benzalkonium Compounds; Candida; Copper; Corneal Ulcer; Dexamethasone; Drug Synergism; Injections; Iritis; Keratitis; Mycoses; Nystatin; Ophthalmic Solutions; Potassium Iodide; Pyridines; Rabbits; Sulfates

Topics: Actinomycosis; Adult; Amphotericin B; Biopsy; Blastomycosis; Coccidioidomycosis; Cryptococcosis; Diagnosis, Differential; Female; Histoplasmosis; Humans; Male; Middle Aged; Mycoses; Nystatin; Respiratory Tract Infections; Skin; Skin Diseases; Skin Ulcer; South America; Sputum

Topics: Female; Humans; Mycoses; Nystatin; Pregnancy; Pregnancy Complications, Infectious; Vaginitis

Topics: Adult; Amphotericin B; Antifungal Agents; Candida; Drug Resistance, Microbial; Female; Griseofulvin; Humans; Male; Middle Aged; Mycoses; Nystatin

Topics: Candida; Candidiasis, Vulvovaginal; Female; Genital Diseases, Female; Genitalia, Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Mycoses; Nystatin; Pregnancy; Pregnancy Complications, Infectious; Yeasts

Topics: Actinomycosis; Adult; Amphotericin B; Aspergillosis; Blastomycosis; Candidiasis, Vulvovaginal; Child; Cryptococcosis; Dermatomycoses; Female; Griseofulvin; Humans; Lung Diseases, Fungal; Mycetoma; Mycoses; Nails; Nocardia Infections; Nystatin; Skin Diseases; Sporotrichosis; Stilbamidines; Thallium; Tinea Pedis

Topics: Acremonium; Aged; Humans; Iodine; Male; Mycoses; Nystatin

Topics: Adrenal Cortex Hormones; Antifungal Agents; Colistin; Corneal Ulcer; Diagnosis, Differential; Herpes Zoster Ophthalmicus; Humans; Idoxuridine; Keratitis; Keratoconus; Mycoses; Natamycin; Nystatin; Polymyxins

Topics: Antifungal Agents; Chloramphenicol; Cornea; Humans; Keratitis; Mycoses; Natamycin; Nystatin; Ointments; Ophthalmic Solutions

Topics: Adult; Amphotericin B; Corneal Transplantation; Corneal Ulcer; Humans; Keratitis; Male; Mycoses; Nystatin; Pseudallescheria

Topics: Adrenal Cortex Hormones; Adult; Contraceptives, Oral; Female; Humans; Mycoses; Nystatin; Vulvovaginitis

Topics: Adolescent; Adult; Child; Child, Preschool; Eosinophilic Granuloma; Female; Griseofulvin; Humans; Indonesia; Infant; Male; Mycoses; Nystatin

Topics: Amphotericin B; Candidiasis; Denmark; Diagnosis; Drug Therapy; Humans; Mouth Diseases; Mycoses; Nystatin; Oral Manifestations; Organic Chemicals

Topics: Biomedical Research; Candida; Candidiasis; Candidiasis, Oral; Drug Therapy; Geriatrics; Humans; Leukoplakia; Leukoplakia, Oral; Mouth Diseases; Mycoses; Nystatin; Pathology; Yeasts

Topics: Adult; Child; Griseofulvin; Humans; Infant; Infant, Newborn; Mycoses; Nystatin; Sulfonamides; Sulfones

Topics: Adrenal Cortex Hormones; Adult; Candida; Conjunctiva; Cornea; Eye Diseases; Fungi; Humans; Male; Mycoses; Nystatin

Topics: Amphotericin B; Humans; Mycoses; Nystatin; Stilbamidines

Topics: Abortion, Veterinary; Animals; Aspergillosis; Diagnosis; Female; Horse Diseases; Horses; Mucormycosis; Mycoses; Nystatin; Pathology; Penicillins; Placenta; Pregnancy; Streptomycin; Therapeutic Irrigation

Topics: Adenoidectomy; Amphotericin B; Anemia; Anti-Bacterial Agents; Ear, Inner; Hemorrhage; Hydrocarbons; Meningitis; Mycoses; Nystatin; Otitis Media; Otolaryngology; Pediatrics; Pharynx; Streptomycin; Tonsillectomy; Toxicology; Vitamins

Topics: Candidiasis; Geriatrics; Humans; Influenza, Human; Lung Diseases, Fungal; Mycoses; Nystatin; Pneumonia

Topics: Child; Enteritis; Geotrichosis; Humans; Infant; Intestines; Mycoses; Nystatin

Topics: Anti-Bacterial Agents; Antibiotics, Antitubercular; Antifungal Agents; Aspergillosis; Biomedical Research; Candidiasis; Humans; Hydrocortisone; Mastoiditis; Mycoses; Nystatin; Otitis Media; Otolaryngology; Penicillium; Postoperative Complications; Surgical Procedures, Operative

Topics: Acremonium; Amphotericin B; Ascomycota; Candidiasis; Cataract; Cataract Extraction; Drug Therapy; Eye Diseases; gamma-Globulins; Griseofulvin; Humans; Mycoses; Nystatin; Postoperative Complications; Steroids; Toxicology

Topics: Candida; Child; Child, Preschool; Cryptococcus; Humans; Infant; Infant, Newborn; Mycoses; Nystatin

Topics: Chloramphenicol; Eyelids; Mycoses; Nystatin; Ointments

Topics: Female; Fungi; Humans; Mycoses; Nystatin; Vulvovaginitis

Topics: Amphotericin B; Antifungal Agents; Aspergillosis; Candidiasis; Erythromycin; Fungi; Gentian Violet; Humans; Iodides; Mycoses; Nystatin; Penicillins; Stilbamidines; Sulfanilamide; Sulfanilamides; Sulfonamides

Topics: Mycoses; Nystatin

Topics: Fungi; Mycoses; Nystatin; Ophthalmology

Topics: Disease; Intestine, Large; Intestines; Mycoses; Nystatin

Topics: Amphotericin B; Antifungal Agents; Aspergillus flavus; Disease; Ethmoid Sinus; Humans; Mycoses; Nystatin; Orbit; Orbital Diseases; Sinusitis

Topics: Anti-Bacterial Agents; Fungi; Griseofulvin; Hypersensitivity; Mycoses; Nystatin

Topics: Child; Disease; Humans; Infant; Lung Diseases; Lymphatic Diseases; Mycoses; Nystatin; Palatine Tonsil; Pharyngeal Diseases

Topics: Anti-Bacterial Agents; Antibiotics, Antitubercular; Antifungal Agents; Dermatologic Agents; Griseofulvin; Mycoses; Nystatin; Organic Chemicals

Topics: Cornea; Corneal Diseases; Disease; Herpesviridae Infections; Keratitis, Herpetic; Mycoses; Nystatin

Topics: Aerosols; Candida; Candidiasis; Lung Diseases; Mycoses; Nystatin; Superinfection

Topics: Animals; Anti-Bacterial Agents; Antifungal Agents; Guanidines; Macrolides; Mice; Mycoses; Nystatin; Stilbamidines; Stilbenes

Topics: Amphotericin B; Animal Experimentation; Animals; Anti-Bacterial Agents; Antifungal Agents; Candida albicans; Candidiasis; Mice; Mucor; Mycoses; Nystatin

Topics: Anti-Bacterial Agents; Dermatologic Agents; Mycoses; Nystatin

Topics: Anti-Bacterial Agents; Humans; Mycoses; Nystatin

Topics: Anti-Bacterial Agents; Antibiotics, Antitubercular; Dermatologic Agents; Mycoses; Nystatin