What is the interaction between Nystatin (an antifungal medication) and Lactobacillus (a probiotic bacterium)?

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Last updated: April 24, 2025View editorial policy

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From the Guidelines

Nystatin and lactobacillus can be used together as complementary treatments for fungal infections, particularly in neonates, with lactobacillus showing potential in reducing fungal infection when used in combination with lactoferrin 1. The use of nystatin, an antifungal medication, is recommended for the prevention of invasive candidiasis in neonates, with a dosage of 1 mL 100 000 IU Q8 h, although it has been noted to reduce fungal infection but not change mortality, and may potentially cause gut damage and necrotizing enterocolitis (NEC) 1.

  • Key points to consider when using nystatin and lactobacillus include:
    • Nystatin's antifungal properties directly target Candida species, making it an effective treatment option.
    • Lactobacillus, particularly when combined with lactoferrin, has been shown to reduce fungal infection in neonates, as seen in studies where lactoferrin 100 mg/day alone or in combination with Lactobacillus 106 colony-forming units per day was administered from the third day of life until either the end of the sixth week of life or until discharge from the NICU 1.
    • The combination of nystatin and lactobacillus may provide a synergistic effect, with nystatin offering immediate antifungal action and lactobacillus helping to prevent recurrence by restoring normal flora.
  • It is essential to weigh the benefits and risks of using these treatments, particularly in vulnerable populations like neonates, and consider the potential for gut damage and NEC associated with nystatin, as well as the emergence of resistant species with other antifungal treatments like fluconazole 1.

From the Research

Nystatin and Lactobacillus

  • There is no direct evidence in the provided studies regarding the relationship between nystatin and lactobacillus.
  • The studies focus on the efficacy of nystatin in treating oral candidiasis and other fungal infections, as well as its safety and potential side effects 2, 3, 4.
  • One study discusses the pathogenesis of fungal infections, antifungal drugs, and alternate treatment approaches, but does not mention lactobacillus specifically 5.
  • Another study discusses invasive fungal infections in the ICU, including candidiasis, and how to approach and treat them, but also does not mention lactobacillus 6.
  • Overall, there is no research evidence provided to assist in answering questions about the relationship between nystatin and lactobacillus.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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