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Nystatin

Nystatin

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Nystatin is a polyene
Polyene antimycotic
Polyene antimycotics, sometimes referred to as polyene antibiotics, are a class of antimicrobial polyene compounds that target fungi. These polyene antimycotics are typically obtained from some species of Streptomyces bacteria. The polyenes bind to ergosterol in the fungal cell membrane and...

 antifungal medication to which many molds and yeast infections are sensitive, including Candida
Candida (genus)
Candida is a genus of yeasts. Many species are harmless commensals or endosymbionts of animal hosts including humans, but other species, or harmless species in the wrong location, can cause disease. Candida albicans can cause infections in humans and other animals, especially in immunocompromised...

. Due to its toxicity
Toxicity
Toxicity is the degree to which a substance can damage a living or non-living organisms. Toxicity can refer to the effect on a whole organism, such as an animal, bacterium, or plant, as well as the effect on a substructure of the organism, such as a cell or an organ , such as the liver...

 profile, there are currently no injectable formulations of this drug on the US market. However, nystatin may be safely given orally as well as applied topically due to its minimal absorption
Absorption (Pharmacokinetics)
In pharmacology , absorption is the movement of a drug into the bloodstream.Absorption involves several phases...

 through mucocutaneous membranes such as the gut and the skin.

Uses


Cutaneous
Skin
-Dermis:The dermis is the layer of skin beneath the epidermis that consists of connective tissue and cushions the body from stress and strain. The dermis is tightly connected to the epidermis by a basement membrane. It also harbors many Mechanoreceptors that provide the sense of touch and heat...

, vagina
Vagina
The vagina is a fibromuscular tubular tract leading from the uterus to the exterior of the body in female placental mammals and marsupials, or to the cloaca in female birds, monotremes, and some reptiles. Female insects and other invertebrates also have a vagina, which is the terminal part of the...

l, mucosal and esophageal
Esophagus
The esophagus is an organ in vertebrates which consists of a muscular tube through which food passes from the pharynx to the stomach. During swallowing, food passes from the mouth through the pharynx into the esophagus and travels via peristalsis to the stomach...

 Candida
Candida (genus)
Candida is a genus of yeasts. Many species are harmless commensals or endosymbionts of animal hosts including humans, but other species, or harmless species in the wrong location, can cause disease. Candida albicans can cause infections in humans and other animals, especially in immunocompromised...

infections usually respond well to treatment with nystatin. Cryptococcus
Cryptococcus
Cryptococcus is a genus of fungus. Species grow in culture as yeasts. The perfect forms or teleomorphs of Cryptococcus species are filamentous fungi in the genus Filobasidiella...

is also sensitive to nystatin. In the UK
United Kingdom
The United Kingdom of Great Britain and Northern IrelandIn the United Kingdom and Dependencies, other languages have been officially recognised as legitimate autochthonous languages under the European Charter for Regional or Minority Languages...

 its licence for treating neonatal oral thrush
Candidiasis
Thrush redirects here. For the hoof infection see Thrush .Candidiasis or thrush is a fungal infection of any of the Candida species , of which Candida albicans is the most common...

 is restricted to those over the age of one month (miconazole
Miconazole
Miconazole is an imidazole antifungal agent, developed by Janssen Pharmaceutica, commonly applied topically to the skin or to mucus membranes to cure fungal infections. It works by inhibiting the synthesis of ergosterol, a critical component of fungal cell membranes...

 is an appropriate alternative for younger babies).

Nystatin is often used as prophylaxis in patients who are at risk for fungal infections, such as AIDS
AIDS
Acquired immune deficiency syndrome or acquired immunodeficiency syndrome is a disease of the human immune system caused by the human immunodeficiency virus...

 patients with a low CD4+ count and patients receiving chemotherapy
Chemotherapy
Chemotherapy is the treatment of cancer with an antineoplastic drug or with a combination of such drugs into a standardized treatment regimen....

.

It is prescribed in units, with doses varying from 100,000 (for oral infections) to 1 million (for intestinal ones). As it is not absorbed from the gut, it is safe for oral use and does not have problems of drug interactions.

It is also used in cellular biology as an inhibitor of the lipid raft
Lipid raft
The plasma membrane of cells is made of a combination of glycosphingolipids and protein receptors organized in glycolipoprotein microdomains termed lipid rafts...

-caveolae
Caveolae
In biology, caveolae , which are a special type of lipid raft, are small invaginations of the plasma membrane in many vertebrate cell types, especially in endothelial cells and adipocytes....

 endocytosis pathway
Endocytosis
Endocytosis is a process by which cells absorb molecules by engulfing them. It is used by all cells of the body because most substances important to them are large polar molecules that cannot pass through the hydrophobic plasma or cell membrane...

 on mammalian cells, at concentrations around 3 µg/mL.

In certain cases, nystatin has been used to prevent the spread of mold on objects such as works of art. For example, it was applied to wood panel paintings damaged as a result of the Arno River Flood of 1966 in Florence, Italy.

Nystatin is also used as a tool by scientists performing "perforated" patch-clamp electrophysiologic recordings of cells. When loaded in the recording pipette, it allows for measurement of electrical currents without washing out the intracellular contents, because it forms pores in the cell membrane that are permeable to only monovalent
Monovalent
Monovalent may refer to:*In chemistry, valence is a measure of the number of chemical bonds formed by the atoms of a given element. Monovalent is a synonym of univalent.*Monovalent ions contain one valence electron....

 ions.

Mechanism of action


Like amphotericin B
Amphotericin B
Amphotericin B is a polyene antifungal drug, often used intravenously for systemic fungal infections...

 and natamycin
Natamycin
Natamycin , also known as pimaricin, is a naturally occurring antifungal agent produced during fermentation by the bacterium Streptomyces natalensis, commonly found in soil. Natamycin has a very low solubility in water, however, natamycin is effective at very low levels. Most molds have an MIC of...

, nystatin binds to ergosterol
Ergosterol
Ergosterol is a sterol found in fungi, and named for ergot, a common name for the members of the fungal genus Claviceps from which ergosterol was first isolated. Ergosterol does not occur in plant or animal cells...

, a major component of the fungal cell membrane
Cell membrane
The cell membrane or plasma membrane is a biological membrane that separates the interior of all cells from the outside environment. The cell membrane is selectively permeable to ions and organic molecules and controls the movement of substances in and out of cells. It basically protects the cell...

. When present in sufficient concentrations, it forms pores in the membrane that lead to K+
Potassium
Potassium is the chemical element with the symbol K and atomic number 19. Elemental potassium is a soft silvery-white alkali metal that oxidizes rapidly in air and is very reactive with water, generating sufficient heat to ignite the hydrogen emitted in the reaction.Potassium and sodium are...

 leakage and death of the fungus. Ergosterol is fairly unique to fungi, so the drug does not have such catastrophic effects on animals.

Origin


Like many other antifungals and antibiotics, nystatin is of bacteria
Bacteria
Bacteria are a large domain of prokaryotic microorganisms. Typically a few micrometres in length, bacteria have a wide range of shapes, ranging from spheres to rods and spirals...

l origin. It was isolated from Streptomyces noursei in 1950 by Elizabeth Lee Hazen
Elizabeth Lee Hazen
Elizabeth Lee Hazen born in Mississippi is most known for her contribution to the development of nystatin. Her education focused on science and research where she developed a passion for microbiology. Her peers and teachers knew her as a quick learner and a bright student...

 and Rachel Fuller Brown
Rachel Fuller Brown
Rachel Fuller Brown was a chemist best known for her long-distance collaboration with microbiologist Elizabeth Lee Hazen in developing the first useful antifungal antibiotic, Nystatin, while doing research for the Division of Laboratories and Research of the New York State Department of Health....

, who were doing research for the Division of Laboratories and Research of the New York State Department of Health. Hazen found a promising micro-organism in the soil of a friend's dairy farm. She named it Streptomyces noursei, after William Nourse, the farm's owner. Hazen and Brown named nystatin after the New York
New York
New York is a state in the Northeastern region of the United States. It is the nation's third most populous state. New York is bordered by New Jersey and Pennsylvania to the south, and by Connecticut, Massachusetts and Vermont to the east...

 State Public Health Department (now known as the Wadsworth Center
Wadsworth Center
The Wadsworth Center, located in Albany, New York, is the research-intensive public health laboratory of the New York State Department of Health. The Wadsworth Center is dedicated to science in the pursuit of health.-History:...

) in 1954.

Brand names

  • Nystan (oral tablets, topical ointment, and pessaries
    Pessary
    A pessary is a small plastic or silicone medical device which is inserted into the vagina or rectum and held in place by the pelvic floor musculature. - Therapeutic pessaries :...

    , formerly from Bristol-Myers Squibb
    Bristol-Myers Squibb
    Bristol-Myers Squibb , often referred to as BMS, is a pharmaceutical company, headquartered in New York City. The company was formed in 1989, following the merger of its predecessors Bristol-Myers and the Squibb Corporation...

    )
  • Infestat
  • Nystalocal from Medinova AG
  • Nystamont
  • Nystop (topical powder, Paddock
    Paddock
    A Paddock is an enclosure for horses. It may also refer to: People*Algernon Paddock , American politician*Charlie Paddock , American athlete and actor*Del Paddock , American baseball player...

    )
  • Nystex
  • Mykinac
  • Nysert (vaginal suppositories, Procter & Gamble
    Procter & Gamble
    Procter & Gamble is a Fortune 500 American multinational corporation headquartered in downtown Cincinnati, Ohio and manufactures a wide range of consumer goods....

    )
  • Nystaform (topical cream, and ointment and cream combined with iodochlorhydroxyquine and hydrocortisone; formerly Bayer
    Bayer
    Bayer AG is a chemical and pharmaceutical company founded in Barmen , Germany in 1863. It is headquartered in Leverkusen, North Rhine-Westphalia, Germany and well known for its original brand of aspirin.-History:...

     now Typharm Ltd)
  • Nilstat (vaginal tablet, oral drops, Lederle)
  • Korostatin (vaginal tablets, Holland Rantos)
  • Mycostatin (vaginal tablets, topical powder, Bristol-Myers Squibb
    Bristol-Myers Squibb
    Bristol-Myers Squibb , often referred to as BMS, is a pharmaceutical company, headquartered in New York City. The company was formed in 1989, following the merger of its predecessors Bristol-Myers and the Squibb Corporation...

    )
  • Mycolog-II (topical ointment, combined with triamcinolone
    Triamcinolone
    Triamcinolone is a long-acting synthetic corticosteroid given orally, by injection, inhalation, or as a topical ointment or cream....

    ; Apothecon)
  • Mytrex (topical ointment, combined with triamcinolone)
  • Mykacet (topical ointment, combined with triamcinolone)
  • Myco-Triacet II (topical ointment, combined with triamcinolone)
  • Flagystatin II (cream, combined with metronidazole)
  • Nistatina (oral tablets, Antibiotice Iaşi
    Antibiotice Iasi
    Antibiotice Iaşi , is a state-owned pharmaceutical company which is the third largest drug producing company in Romania and the second largest nystatin producer in the world. Its research center and production facilities are based in Valea Lupului, a commune near Iaşi.-External links:* * *...

    )
  • Nidoflor (cream, combined with neomycin sulfate and triamcinolone acetonide
    Triamcinolone acetonide
    Triamcinolone acetonide is a synthetic corticosteroid used to treat various skin conditions and to relieve the discomfort of mouth sores. It is a more potent type of triamcinolone, being about 8 times as effective as prednisone.-Medical use:...

    , Antibiotice Iaşi
    Antibiotice Iasi
    Antibiotice Iaşi , is a state-owned pharmaceutical company which is the third largest drug producing company in Romania and the second largest nystatin producer in the world. Its research center and production facilities are based in Valea Lupului, a commune near Iaşi.-External links:* * *...

    )
  • Stamicin (oral tablets, Antibiotice Iaşi
    Antibiotice Iasi
    Antibiotice Iaşi , is a state-owned pharmaceutical company which is the third largest drug producing company in Romania and the second largest nystatin producer in the world. Its research center and production facilities are based in Valea Lupului, a commune near Iaşi.-External links:* * *...

    ) see http://www.farmaline.ro/index.php?cid=1&pid=357
  • Lystin
  • Animax (veterinary topical ointment or cream; combined with neomycin sulfate, thiostrepton
    Thiostrepton
    Thiostrepton is a natural cyclic oligopeptide antibiotic, derived from several strains of strepromycetes, such as Streptomyces azureus and Streptomyces laurentii.- History :...

     and triamcinolone acetonide
    Triamcinolone acetonide
    Triamcinolone acetonide is a synthetic corticosteroid used to treat various skin conditions and to relieve the discomfort of mouth sores. It is a more potent type of triamcinolone, being about 8 times as effective as prednisone.-Medical use:...

    )