Nystatin showed a potentially higher effect in inhibition of candida attachment and colonization (P = 0.0001) compared to that of fluconazole and a statistically significant difference was seen between 5% and 1% fluconazole (P = 0.0001).
The first-choice oral option is fluconazole (Diflucan). It's available as tablets or a liquid suspension. If fluconazole doesn't work or you have a bad reaction to it, itraconazole solution (Sporanox) and posaconazole suspension (Noxafil) are alternative options.
Diflucan (fluconazole) and nystatin are antifungal medications used to treat Candida fungal infections. Diflucan is also used to treat fungal meningitis and may be prescribed to ward off fungal infections in patients being treated with chemotherapy or radiation before a bone marrow transplant.
Conclusion: Itraconazole was found to be more effective in the treatment of vulvovaginal candidiasis compared to fluconazole with high cure and low relapse rate.
This leaves nystatin, a poor antifungal, as the only topical polyene for the treatment of oral candidiasis.
In addition to being nontoxic and better tolerated, ketoconazole appeared to be slightly more effective than nystatin in reducing locally severe yeast infections.
Nystatin is the current standard topical treatment for oral candidiasis and fluconazole is the most common systemic antifungal used alternative to topical nystatin7.
Itraconazole has in-vitro activity against a greater range of Candidaspecies than fluconazole. Capsule formulation. Itraconazole capsules are effective and indicated for the treatment of a number of localized and systemic fungal infections in adults, irrespective of their immune status (Table II).
Candida infections may resist antifungal drugs, making them difficult to treat. About 7% of all Candida blood samples tested at CDC are resistant to the antifungal drug fluconazole.
Best pill: Fluconazole
Fluconazole is a generic version of the prescription pill Diflucan, which people can take to treat yeast infections. Individuals need to take a single pill first. If symptoms do not improve after 2 days, they can take a second pill.
Interactions between your drugs
No interactions were found between fluconazole and nystatin. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.
Studies on denture stomatitis showed that using nystatin pastilles for 2 weeks could achieve a 14.3%–28.6% clinical cure rate and a 57.1%–71.4% mycological cure rate27 and that using the pastille form for 4 weeks could achieve a 76.9% clinical cure rate and a 40% mycological cure rate.
The problem is, yeast bud divides about every 90 minutes. Thus, the Nystatin can't possibly keep up with the yeast's rate of division, so in my experience, it's not very effective. Further, it's a prescription, so most physicians will require an office visit to prescribe it.
Your doctor may prescribe fluconazole if miconazole or nystatin have not treated your oral thrush, or if your infection is severe. Fluconazole comes as a capsule or liquid that you swallow, your body absorbs it for it to work. This means that it affects more of your body and has a stronger effect.
Results. Nystatin and miconazole are the most commonly used topical antifungal drugs. Both antifungal drugs are very effective but need a long time of use to eradicate the infection.
Thrush is easily treated with an antifungal medicine such as nystatin (Mycostatin®), fluconazole (Diflucan®), or itraconazole (Sporanox®). Your child may get these medicines as a syrup or a pill. Thrush usually clears up in 4 to 5 days.
Talk to your doctor if your symptoms do not improve after 7 days of taking fluconazole for vaginal thrush, balanitis or oral thrush. Your doctor may ask you to take it for longer, or they may prescribe a different antifungal treatment. If your symptoms get worse at any time, speak to your doctor.
Some species of fungi are naturally resistant to certain types of antifungal drugs. For example, the drug fluconazole does not work against infections caused by the fungus Aspergillus, a type of mold found throughout the environment. Resistance can also develop over time when fungi are exposed to antifungal drugs.
Amphotericin acts as a detergent by binding to ergosterol in the fungal cell membrane and causing the intracellular contents of the fungal cell to leak out causing cell death. As discussed, it is the most broad spectrum and therefore has the most clinical indications.
Among the six systemic antifungals tested, fluconazole, griseofulvine, itraconazole, ketoconazole, terbinafine, and voriconazole, the allylamine terbinafine was the most potent agent.
Treatment for Invasive Candidiasis
For most adults, the initial recommended antifungal treatment is an echinocandin (caspofungin, micafungin, or anidulafungin) given through the vein (intravenous or IV). Fluconazole, amphotericin B, and other antifungal medications may also be appropriate in certain situations.
Nystatin is a polyene antifungal drug that has broad-spectrum fungicidal and fungistatic activity against a number of yeasts and fungi, most notably Candida species.
Resistance to nystatin is rare, although the drug's contact killing makes it somewhat more difficult to use because it must be applied to all of the affected mucosal surfaces to be effective (unlike systemic therapies). Failures with nystatin are more common than with fluconazole.