This is topic Diflucan vs. Nystatin in forum Medical Questions at LymeNet Flash.

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Posted by muddyfeet (Member # 26633) on :
I'm finally about to start abx treatment next week.

I've been to a "lyme friendly" doctor and today went to an LLNP.

I was prescribed Azithromycin (Zithromax) 500mg 1x day and Cefdinir (Omnicef) 300mg 2x day.

My LLNP wants me to start on probiotics (20 billion 1-2x day) and an anti-fungal for a week before starting the abx.

I tend to be very yeast prone. If I just look at abx I will get a vaginal yeast infection!, Well, that's what it feels like at least!!! In addition, I got a yeast infection in my esophagus a few years back after a couple of months on abx (unrelated to lyme).

So, obviously I am wanting to be as preventative as possible.

I've been taking Florastor for about a month.

I was given Nystatin by the "lyme friendly" dr. who told me it was better than Diflucan because it goes directly into your intestines.

However, the LLNP that I saw today told me she prefers Diflucan.

Can anyone tell me if they feel there is a difference in effectiveness between Nystatin and Diflucan?

Also, does the dosage of Nystatin seem strong enough? On other posts people talk about taking 4 pills a day. I've only been prescribed 1 pill a day at 500,000 unit a pill.

Also, she told me it was fine to continue the Florastor as long as I took the Nystatin or Diflucan 2 hours after. Is this correct?

Currently the lymenet site won't let me update my signature so here are my results below:

Labcorp 6/2010: IGM Positive 41, 39, 23

IGenex 7/2010:
IFA Indeterminate
IGenex/CDC IgM Positive:
18+, 23-25+, 30+, 31+++, 34++, 39++, 41++, 58++, 66+, 83-93+
IGenex IgG Positive:
31+, 34 IND, 41++, 58+

No memory of tick or rash. Sick since 1/09. Diagnosed CFIDS 7/09. Diagnosed Lyme 7/2010.
Posted by debamongorangeblossoms (Member # 28167) on :
I was just diagnosed yesterday (although I think I've had Lyme's for years)... I too, am interested in anything that will help with yeast. I'll be starting Zithromax in about a week, and will be on it for some time.

Thanks for asking the question!
Posted by jkmom (Member # 14004) on :
My daughter's LLMD has her on 2 Nystatin pills daily. At times, he has also had her take Diflucan. I think he thinks Diflucan has more side effect potential than Nystatin because he doesn't keep her on that indefinitely.

My LLMD uses Diflcan as needed but nothing for prevention.

I think, but I could be wrong, that Nystatin does work on GI yeast but would not work on vaginal yeast.
Posted by janet thomas (Member # 7122) on :
One of the nationally known LLMDs (the other Dr B in NY) treated me with ketek & bicillin.

Right from the start he also prescribed nystatin, 4 pills 4 times a day and diflucan, 100 mg twice a day.

Nystatin is not systemic but stays in the gut while diflucan is systemic.

Nystatin is safe enough for pediatric use.
Posted by janet thomas (Member # 7122) on :
Forgot to mention Lactoferrin. Since using this I haven't needed nystatin or diflucan. I take 250mg daily of Jarrows lactoferrin.

Antifungal activity
Lactoferrin and lactoferricin inhibit in vitro growth of Trichophyton mentagrophytes, which are responsible for several skin diseases such as ringworm.[36] Lactoferrin also acts against the Candida albicans - a diploid fungus (a form of yeast) that causes opportunistic oral and genital infections in humans.[37][38] Fluconazole has long been used against Candida albicans, which resulted in emergence of strains resistant to this drug. However, a combination of lactoferrin with fluconazole can act against fluconazole-resistant strains of Candida albicans as well as other types of Candida: C. glabrata, C. krusei, C. parapsilosis and C. tropicalis.[37] Antifungal activity is observed for sequential incubation of Candida with lactoferrin and then with fluconazole, but not vice versa. The antifungal activity of lactoferricin exceeds that of lactoferrin. In particular, synthetic peptide 1-11 lactoferricin shows much greater activity against Candida albicans than native lactoferricin.[37]

Administration of lactoferrin through drinking water to mice with weakened immune systems and symptoms of aphthous ulcer reduced the number of Candida albicans strains in the mouth and the size of the damaged areas in the tongue.[39] Oral administration of lactoferrin to animals also reduced the number of pathogenic organisms in the tissues close to the gastrointestinal tract. Candida albicans could also be completely eradicated with a mixture containing lactoferrin, lysozyme and introakonazol in HIV-positive patients who were resistant to other antifungal drugs.[40] Such antifungal action when other drugs deem inefficient is characteristic of lactoferrin and is especially valuable for HIV-infected patients.[41] Contrary to the antiviral and antibacterial actions of lactoferrin, very little is known about the mechanism of its antifungal action. Lactoferrin seem to destroy the cell wall and binds the plasma membrane of C. albicans.[38
Posted by janet thomas (Member # 7122) on :
sorry, double post
Posted by Lymetoo (Member # 743) on :
One pill of Nystatin won't do much if you ask me. My dr had me on 16 pills a day for a week or two.. then went to maintenance of 4 pills a day.

I stayed on that the whole time I was on abx.
Posted by muddyfeet (Member # 26633) on :
This is helpful. I need to get in touch with my LLNP. If Nystatin doesn't prevent vaginal yeast infections then I may need to be on both. I also need to ask about dosage.

Posted by janet thomas (Member # 7122) on :
Douching with one part apple cider vinegar to 3 parts water helps with vaginal yeast infections.

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