What is Nystatin?
Nystatin is an antifungal medication frequently used in the field of
Infectious Diseases to treat fungal infections, particularly those caused by
Candida species. It is a polyene antifungal, which means it works by binding to sterols in the cell membrane of fungi, causing cell contents to leak out, ultimately leading to cell death. Unlike many other antifungals, nystatin is not absorbed systemically when administered orally, making it particularly useful for treating localized infections.
What Infections Does Nystatin Treat?
Nystatin is primarily used to treat mucocutaneous candidiasis. This includes
oral thrush, which is a fungal infection of the mouth, and
esophageal candidiasis, as well as cutaneous infections like
diaper rash and intertrigo. It is also used in managing
vaginal yeast infections and can be administered topically or as an oral suspension, depending on the location and severity of the infection.
How is Nystatin Administered?
Nystatin can be administered in several forms, including oral suspension, tablets, and topical creams or ointments. The choice of formulation depends on the type and location of the infection. For example, oral suspension might be used for treating oral thrush, while creams or ointments are applied to the skin for cutaneous infections. The oral form is swished in the mouth and swallowed to treat infections in the mouth and throat.
What are the Side Effects of Nystatin?
While generally well-tolerated, nystatin can cause some side effects.
Oral administration may lead to nausea, vomiting, diarrhea, or gastrointestinal upset. Topical application could result in skin irritation, burning, or itching. It is important to monitor patients for any allergic reactions or severe side effects, although these are relatively rare.
Are There Any Drug Interactions?
Nystatin is primarily used locally and is not absorbed into the
bloodstream in significant amounts, which minimizes potential drug interactions. However, it is always important to review a patient's current medications to ensure there are no contraindications or potential interactions, especially with other medications that have systemic effects.
What are the Resistance Mechanisms?
Resistance to nystatin is uncommon, particularly because it is not used systemically and only affects fungi directly exposed to it. However, in rare cases, overuse or misuse can lead to the development of resistant strains. The mechanism typically involves alterations in the fungal cell membrane that reduce nystatin's binding ability.
How Does Nystatin Compare to Other Antifungals?
Nystatin is unique among antifungals because it is not absorbed into the bloodstream when taken orally, making it ideal for treating localized infections. Other antifungals, such as
fluconazole or
itraconazole, are absorbed systemically and are used for more severe or widespread infections. Nystatin's lack of systemic absorption limits its use to surface or mucosal infections, but it also reduces the risk of systemic side effects and interactions.
Is Nystatin Safe for All Patients?
Nystatin is generally considered safe for a wide range of patients, including children and pregnant women, due to its lack of systemic absorption. However, it should be used with caution in patients with known allergies to antifungal agents. As always, healthcare providers should carefully evaluate each patient's condition and history before prescribing nystatin.
