To : Laureen
Re : Reference for Nystatin resistance

From the following data roughtly 48 % of candida strains were resistant to
nystatin, which is what we see clinically all the time.


 From Micromedix DrugDex:

Oral fluconazole achieved a higher clinical cure rate than oral nystatin in
HIV-infected patients with oral candidiasis. In this prospective,
randomized, multicenter study 138 patients received fluconazole oral
suspension 100 milligrams (mg) once daily for 14 days (with a 200 mg loading
dose on day 1) or nystatin oral suspension 500,000 units swish-retain-
swallow four times daily for 14 days. Fluconazole achieved a higher clinical
cure rate at 14 days (87%) than the nystatin group (52%; p less than 0.001),
a higher rate of eradication of Candida species by the end of treatment day
14 (60% versus 6%, respectively), and a lower rate of relapse at day 28 (18%
versus 44%, respectively; p less than 0.001) in the fluconazole-treated
patients. However, no difference in relapse rates was observed between the 2
groups at the end of follow-up on day 42.

Pons V, Greenspan D, Lozada-Nur F et al: Oropharyngeal candidiasis in
patients with AIDS: randomized comparison of fluconazole versus nystatin
oral suspensions. Clin Infect Dis 1997; 24:1204-1207.


Regards
Tom Hale, Ph.D.