YEAST INFECTIONS

Am J Clin Nutr. 1999 Jun;69(6):1170-3. Related Articles, Links

Limited effect of refined carbohydrate dietary supplementation on colonization of the gastrointestinal tract of healthy subjects by Candida albicans.

Weig M, Werner E, Frosch M, Kasper H.

Institut fur Hygiene und Mikrobiologie, Klinik und Poliklinik fur Nuklearmedizin der Universitat Wurzburg, Germany. mweig@hygiene.uni-wuerzburg.de

BACKGROUND: Infections due to Candida albicans occur readily in situations in which ample glucose is available. In mice, dietary refined carbohydrate supplementation leads to higher rates of Candida growth in the gastrointestinal tract and favors mucosal invasion. OBJECTIVE: The modulating properties of dietary carbohydrate supplementation on colonization of the human gastrointestinal tract by C. albicans were evaluated. DESIGN: A 2-step study was conducted in 28 healthy volunteers. First, we determined the subjects' habitual uptake of refined carbohydrates and correlated these data with the C. albicans blastoconidia concentration in the mouth washes and feces of subjects with no intervention. Second, we compared C. albicans counts in the specimens before, during, and after a high-sugar diet. RESULTS: No correlation between C. albicans counts in the specimens and the habitual uptake of refined carbohydrates was observed. A high-sugar diet did not increase the frequency of C. albicans-positive samples, the number of subjects positive for C. albicans in the mouth washes, or the concentration of candidal blastoconidia in the samples of the 28 subjects. However, in selected subjects with elevated counts of oral C. albicans, we observed an increase in fecal C. albicans counts in response to the diet. CONCLUSIONS: The effect of adding a high amount of refined carbohydrates to the diet of healthy human subjects has a limited influence on Candida colonization. Follow-up studies should define whether selected patient groups might benefit from dietary restriction of refined carbohydrates.

Publication Types:

Clinical Trial

PMID: 10357735 [PubMed - indexed for MEDLINE]

Infect Immun. 1993 Feb;61(2):619-26. Related Articles, Links

Modulating effect of dietary carbohydrate supplementation on Candida albicans colonization and invasion in a neutropenic mouse model.

Vargas SL, Patrick CC, Ayers GD, Hughes WT.

Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, Tennessee.

We studied the effect of dietary carbohydrate supplementation on Candida albicans colonization and invasion of the gastrointestinal tract in a neutropenic mouse model. Mice inoculated with C. albicans were allowed free access to standard chow and drinking water supplemented with either glucose or xylitol or no carbohydrates (control). On days 33 through 36 postinoculation, the mean +/- standard error log10 CFU of C. albicans per gram on the mucosal surface, determined by quantitating CFU dislodged in the first wash of the gastric wall, was significantly higher in mice given the glucose supplement: 7.20 +/- 0.09 (glucose) versus 5.38 +/- 0.28 (xylitol) and 5.11 +/- 0.33 (control) CFU/g (P < or = 0.05 for each comparison by Fisher's protected least-significant-difference test). Fecal cultures also yielded the highest quantities of C. albicans in the glucose group. Invasion of the gastric wall by C. albicans correlated well with surface colonization in glucose-supplemented animals. Eight of 10 mice in this group, all with > 10(6) CFU/g, showed extensive invasive growth, as compared with only 2 of 26 mice in the remaining groups (P = 0.00006 by Fisher's exact test). These results indicate that dietary glucose intake is a key determinant of C. albicans growth in the gastrointestinal tract. The data provide an experimental rationale for clinical trials to decrease the intake of glucose or its utilization by C. albicans in immunocompromised patients.

PMID: 8423091 [PubMed - indexed for MEDLINE]

Mycopathologia. 2002;156(1):9-11. Related Articles, Links

Intestinal candidiasis. A clinical report and comments about this opportunistic pathology.

Ruiz-Sanchez D, Calderon-Romero L, Sanchez-Vega JT, Tay J.

Laboratory of Parasitology, Department of Microbiology and Parasitology, Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico. letycr@servidor.unam

An eight-years-old girl, who presented with recurrent upper respiratory tract infections, was treated with broad-spectrum antibiotics. Afterward she presented with intestinal candidiasis. The isolated species was identified as Candida albicans by differential tests. Treatment given was with 500,000 IU of oral nystatin every 8 hours for 10 days and intestinal normal microbiota restoratives. Evolution has been satisfactory, although concomitantly type A hepatitis developed. Rest and a soft diet were recommended. The child is now perfectly healthy with normal liver function tests. CONCLUSION: Prolonged treatments with broad-spectrum antibiotics destroyed the indigenous intestinal microbiota, which provoked intestinal C. Albicans proliferation and adversely affected the immunological system of the patient, thus facilitating the establishment of a viral infection.

Publication Types:

Case Reports

PMID: 12715941 [PubMed - indexed for MEDLINE]

Antimicrob Agents Chemother. 1994 Mar;38(3):602-3. Related Articles, Links

Effects of broad-spectrum antibiotics on colonization of gastrointestinal tracts of mice by Candida albicans.

Samonis G, Anastassiadou H, Dassiou M, Tselentis Y, Bodey GP.

Department of Medical Oncology, University of Crete, Heraklion, Greece.

Three-month-old, male, Crl:CD1 (ICR) BR mice were fed chow containing Candida albicans or regular chow. Subsequently, both groups were given either antibiotics or normal saline for 10 days. Stool cultures were performed immediately before administration, at the end of antibiotic administration, and 1 week after the discontinuation of antibiotics, to determine the effect on the concentration of C. albicans in the stools. The stools of mice fed C. albicans and given antibiotics had substantially higher Candida counts than those of control mice fed C. albicans and given saline. Significantly higher candidal concentrations were observed in the stools of mice given chloramphenicol compared with those of mice given ciprofloxacin, sulfamethoxazole-trimethoprim, and ampicillin. No mice developed histopathological evidence of local gastrointestinal invasion or disseminated candidiasis. In this mouse model, Candida colonization increases substantially after the administration of antimicrobial agents with broad spectra and anaerobic activities.

PMID: 8203861 [PubMed - indexed for MEDLINE]

New Microbiol. 2000 Jan;23(1):63-71. Related Articles, Links

Effect of dietary carbohydrates on the in vitro epithelial adhesion of Candida albicans, Candida tropicalis, and Candida krusei.

Pizzo G, Giuliana G, Milici ME, Giangreco R.

Department of Periodontology, School of Dentistry, University of Patermo, Italy.

Adhesion to epithelial surfaces is considered as a critical step in the pathogenesis of oral candidosis. Therefore, the effects of the most commonly consumed dietary carbohydrates on the adhesion of Candida albicans, Candida tropicalis, and Candida krusei to monolayered HeLa cells were investigated. Adherence of C. albicans and C. tropicalis appeared significantly promoted by incubation in defined medium containing a high concentration (500 mM) of fructose, glucose, maltose, and sucrose (p < 0.001). C. albicans organisms grown in sucrose elicited maximal increase in adhesion, whereas adhesion of C. tropicalis and C. krusei was enhanced to the greatest extent when cultured in glucose. Maltose and fructose also promoted adherence of C. albicans and C. tropicalis (p < 0.001), but to a lesser extent than sucrose and glucose. On the other hand, sorbitol-grown yeasts demonstrated a marginal increase in adhesion (p > 0.01). Xylitol only significantly reduced adherence of C. albicans (p < 0.001). These results suggest that the frequent consumption of carbohydrates, such as sucrose, glucose, maltose, or fructose, might represent a risk factor for oral candidosis. The limitation of their consumption by substituting xylitol or sorbitol could be of value in the control of oral Candida colonization and infection.

PMID: 10946407 [PubMed - indexed for MEDLINE]

BMJ. 2004 Sep 4;329(7465):548. Epub 2004 Aug 27. Related Articles, Links

Effect of lactobacillus in preventing post-antibiotic vulvovaginal candidiasis: a randomised controlled trial.

Pirotta M, Gunn J, Chondros P, Grover S, O'Malley P, Hurley S, Garland S.

Department of General Practice, 200 Berkeley Street, Carlton, Victoria, Australia, 3053. m.pirotta@unimelb.edu.au

OBJECTIVE: To test whether oral or vaginal lactobacillus can prevent vulvovaginitis after antibiotic treatment. DESIGN: Randomised, placebo controlled, double blind, factorial 2x2 trial. SETTING: Fifty general practices and 16 pharmacies in Melbourne, Australia. PARTICIPANTS: Non-pregnant women aged 18-50 years who required a short course of oral antibiotics for a non-gynaecological infection: 278 were enrolled in the study, and results were available for 235. INTERVENTIONS: Lactobacillus preparations taken orally or vaginally, or both, from enrollment until four days after completion of their antibiotic course. MAIN OUTCOME MEASURES: Participants' reports of symptoms of post-antibiotic vulvovaginitis, with microbiological evidence of candidiasis provided by a self obtained vaginal swab. RESULTS: Overall, 55/235 (23% (95% confidence interval 18% to 29%)) women developed post-antibiotic vulvovaginitis. Compared with placebo, the odds ratio for developing post-antibiotic vulvovaginitis with oral lactobacillus was 1.06 (95% confidence interval 0.58 to 1.94) and with vaginal lactobacillus 1.38 (0.75 to 2.54). Compliance with antibiotics and interventions was high. The trial was terminated after the second interim analysis because of lack of effect of the interventions. Given the data at this time, the chances of detecting a significant reduction in vulvovaginitis with oral or vaginal lactobacillus treatment were less than 0.032 and 0.0006 respectively if the trial proceeded to full enrollment. CONCLUSIONS: The use of oral or vaginal forms of lactobacillus to prevent post-antibiotic vulvovaginitis is not supported by these results. Further research on this subject is unlikely to be fruitful, unless new understandings about the pathogenesis of post-antibiotic vulvovaginitis indicate a possible role for lactobacillus.

Publication Types:

Clinical Trial

Multicenter Study

Randomized Controlled Trial

PMID: 15333452 [PubMed - indexed for MEDLINE]

J Assoc Nurses AIDS Care. 2001 Jul-Aug;12(4):51-7. Related Articles, Links

Evaluation of two self-care treatments for prevention of vaginal candidiasis in women with HIV.

Williams AB, Yu C, Tashima K, Burgess J, Danvers K.

Yale University School of Nursing, USA.

Vaginal candidiasis (VC) is a common concern for women living with HIV infection. The authors evaluated the effectiveness of two self-care approaches to prophylaxis of VC among HIV-infected women, weekly intravaginal application of Lactobacillus acidophilus or weekly intravaginal application of clotrimazole tablets, in a randomized, double-blind, placebo-controlled trial. VC was defined as a vaginal swab positive for Candida species in the presence of signs/symptoms of vaginitis and the absence of a diagnosis of Trichomonas vaginalis or bacterial vaginosis. Thirty-four episodes of VC occurred among 164 women followed for a median of 21 months. The relative risk of experiencing an episode of VC was 0.4 (95% CI = 0.2, 0.9) in the clotrimazole arm and 0.5 (95% CI = 0.2, 1.1) in the Lactobacillus acidophilus arm. The estimated median time to first episode VC was longer for clotrimazole (p = .03, log rank test) and Lactobacillus acidophilus (p = .09, log rank test) compared with placebo. Vaginal yeast infections can be prevented with local therapy. Education about self-care for prophylaxis of VC should be offered to HIV-infected women.

Publication Types:

Clinical Trial

Multicenter Study

Randomized Controlled Trial

PMID: 11486720 [PubMed - indexed for MEDLINE]

J Obstet Gynecol Neonatal Nurs. 2003 May-Jun;32(3):287-96. Related Articles, Links

Prevention and treatment of vulvovaginal candidiasis using exogenous Lactobacillus.

Jeavons HS.

Planned Parenthood, Seattle, WA, USA. heatherstarshine@hotmail.com

OBJECTIVE: To review literature examining exogenous Lactobacillus therapy for vulvovaginal candidiasis and to discuss recommendations for clinical practice and future research. DATA SOURCES: Computerized searches on MEDLINE and CINAHL November 2000, September 2001, and March 2002, with search terms including Lactobacillus, acidophilus, Candida, and yeast infections. STUDY SELECTION: Relevant English-language articles from the past 10 years. Unique or seminal studies included where pertinent. DATA EXTRACTION AND SYNTHESIS: Data organized under the following headings: endogenous Lactobacillus, exogenous Lactobacillus, Candida, studies of intravaginal Lactobacillus therapy for vulvovaginal candidiasis, studies of oral Lactobacillus therapy for vulvovaginal candidiasis. CONCLUSIONS: Vaginally administered or orally ingested Lactobacillus is able to colonize the vaginal ecosystem. Controlled intervention studies regarding the effect of such colonization on vulvovaginal candidiasis are promising but few. These studies had small numbers of participants, were inconsistent in the form of Lactobacillus used, and reported conflicting results. Further randomized controlled trials involving large numbers of women are imperative. In the meantime, health care providers should discuss potential benefits with affected patients while clarifying the current lack of conclusive evidence. Without further research into currently available sources and brands of Lactobacillus and without governmental regulation of supplements and their contents, however, it is difficult to make recommendations regarding appropriate product choice.

Publication Types:

Review

Review, Tutorial

PMID: 12774870 [PubMed - indexed for MEDLINE]

Mayo Clin Proc. 2001 Sep;76(9):883-9. Related Articles, Links

Lack of effect of Lactobacillus GG on antibiotic-associated diarrhea: a randomized, placebo-controlled trial.

Thomas MR, Litin SC, Osmon DR, Corr AP, Weaver AL, Lohse CM.

Division of Community Internal Medicine, Mayo Clinic, Rochester, Minn 55905, USA.

OBJECTIVES: To assess the efficacy of Lactobacillus GG in preventing antibiotic-associated diarrhea (AAD) in adults and, secondarily, to assess the effect of coadministered Lactobacillus GG on the number of tests performed to determine the cause of diarrhea. PATIENTS AND METHODS: In this prospective, randomized, double-blind, placebo-controlled trial conducted from July 1998 to October 1999, 302 hospitalized patients receiving antibiotics were randomized to receive Lactobacillus GG, 20 x 10(9) CFU/d, or placebo for 14 days. Subjects recorded the number of stools and their consistency daily for 21 days. The primary outcome was the proportion of patients who developed diarrhea in the first 21 days after enrollment. Weekly telephone follow-up was also performed. Results were analyzed in an intention-to-treat fashion. RESULTS: Diarrhea developed in 39 (29.3%) of 133 patients randomized to receive Lactobacillus GG and in 40 (29.9%) of 134 patients randomized to receive placebo (P=.93). No additional difference in the rate of occurrence of diarrhea was found between treatment and placebo patients in a subgroup analysis of those treated with beta-lactam vs non-beta-lactam antibiotics. Too few patients had stool cultures, additional laboratory tests for diarrhea, or a positive diagnosis of Clostridium difficile infection to assess between-group differences. CONCLUSION: Lactobacillus GG in a dose of 20 x 10(9) CFU/d did not reduce the rate of occurrence of diarrhea in this sample of 267 adult patients taking antibiotics initially administered in the hospital setting.

Publication Types:

Clinical Trial

Randomized Controlled Trial

PMID: 11560298 [PubMed - indexed for MEDLINE]

J Pediatr. 1999 Nov;135(5):564-8. Related Articles, Links

Comment in:

J Pediatr. 1999 Nov;135(5):535-7.

Lactobacillus GG in the prevention of antibiotic-associated diarrhea in children.

Vanderhoof JA, Whitney DB, Antonson DL, Hanner TL, Lupo JV, Young RJ.

Department of Pediatrics, University of Nebraska, Omaha, USA.

OBJECTIVE: The objective of this study was to determine the efficacy of Lactobacillus casei sps. rhamnosus (Lactobacillus GG) (LGG) in reducing the incidence of antibiotic-associated diarrhea when coadministered with an oral antibiotic in children with acute infectious disorders. STUDY DESIGN: Two hundred two children between 6 months and 10 years of age were enrolled; 188 completed all phases of the protocol. LGG, 1 x 10(10) - 2 x 10(10) colony forming units per day, or comparable placebo was administered in a double-blind randomized trial to children receiving oral antibiotic therapy in an outpatient setting. The primary caregiver was questioned every 3 days regarding the incidence of gastrointestinal symptoms, predominantly stool frequency and consistency, through telephone contact by blinded investigators. RESULTS: Twenty-five placebo-treated but only 7 LGG-treated patients had diarrhea as defined by liquid stools numbering 2 or greater per day. Lactobacillus GG overall significantly reduced stool frequency and increased stool consistency during antibiotic therapy by the tenth day compared with the placebo group. CONCLUSION: Lactobacillus GG reduces the incidence of antibiotic-associated diarrhea in children treated with oral antibiotics for common childhood infections.

Publication Types:

Clinical Trial

Randomized Controlled Trial

PMID: 10547243 [PubMed - indexed for MEDLINE]

Antimicrob Agents Chemother. 2002 Nov;46(11):3499-505. Related Articles, Links

Antifungal activity of amphotericin B, fluconazole, and voriconazole in an in vitro model of Candida catheter-related bloodstream infection.

Lewis RE, Kontoyiannis DP, Darouiche RO, Raad II, Prince RA.

University of Houston College of Pharmacy, Houston, Texas 77030, USA. rlewis@uh.edu

The activity of five simulated antifungal regimens for eradication of catheter-related bloodstream Candida infection was evaluated with an in vitro pharmacodynamic model. Single-lumen central venous catheters were colonized with Candida species by sequentially incubating central venous catheters in plasma and then in growth medium (RPMI plus morpholinepropanesulfonic acid) containing a standardized suspension (10(5) CFU/ml) of Candida albicans, Candida glabrata, or slime-producing Candida parapsilosis. Colonized central venous catheters were then placed in a one-compartment pharmacodynamic model where five antifungal regimens (plus control) were simulated: amphotericin B, 1.0 mg/kg every 24 h; amphotericin B, 0.5 mg/kg every 24 h; fluconazole, 400 mg every 24 h; fluconazole, 800 mg every 24 h; and voriconazole, 4 mg/kg every 12 h. During exposure to the simulated clinical regimens, samples were serially removed from the model over 48 h for quantitation of viable organisms. All antifungal regimens suppressed fungal counts by both peripheral and catheter sampling versus control (P = 0.001). Overall, antifungal activity ranked amphotericin B (1 mg/kg) > amphotericin B (0.5 mg/kg) > or = voriconazole > fluconazole (800 mg) > or = fluconazole (400 mg). No regimen, however, completely eradicated (by culture and electron microscopy) central venous catheter colonization. Regrowth was noted in the model during therapy against C. glabrata and C. parapsilosis but was not associated with an increase in the MICs for the isolates. Lack of in vitro antifungal activity against biofilm-encased organisms appeared to be the primary reason for mycological failure of antifungal regimens in the model.

PMID: 12384356 [PubMed - indexed for MEDLINE]

Oral Dis. 2002;8 Suppl 2:69-75. Related Articles, Links

Immunity to Candida.

Fidel PL Jr.

Department of Microbiology, Immunology, and Parasitology, Louisiana State University Health Sciences Center, New Orleans, USA. pfidel@lsumc.edu

Candida species are commensal fungal organisms as well as opportunistic pathogens of mucosal tissues. From the commensal relationship, most healthy individuals have demonstrable Candida-specific immunity. In immunocompromised persons, however, fungal infections caused primarily by C. albicans often occur. In HIV disease, up to 90% of HIV+ persons will have a symptomatic episode of oropharyngeal candidiasis (OPC) sometime during progression to AIDS, many of which become recurrent. In contrast, vulvovaginal candidiasis (VVC) and systemic Candida infections (candidaemia) are much less common during HIV disease, indicating the diversity and compartmentalization of the host response to Candida. Both innate resistance and acquired immunity play some role in maintaining C. albicans in the commensal state and protecting the systemic circulation. Polymorphonuclear leukocytes (PMNL) are critical for protection against systemic infections, whereas cell-mediated immunity (CMI) by Th1-type CD4+ T-cells is important for protection against mucosal infections. However, there is a discordant role for CMI at the vaginal versus oral mucosa, whereas little to no role for local or systemic CMI is evident at the vaginal mucosa. In contrast, there is a strong correlation between reduced blood CD4+ cells and the incidence of OPC, but it remains unclear whether systemic or local CMI is more important. Evaluation of systemic CMI in a cohort of HIV+ individuals with and without mucosal candidiasis revealed that Candida-specific CMI is not different between HIV+ persons with OPC or VVC and HIV- persons. Thus, the correlation of reduced CD4+ cell numbers to OPC may be explained by the requirement for a threshold number of systemic CD4+ cells to protect the oral mucosa together with the status of local immunity. Indeed, HIV+ persons with and without OPC had a Th2-type salivary cytokine profile suggestive of susceptibility to Candida infection compared with a protective Th0/Th1-type profile in HIV- persons. Candida-specific antibodies, although present, are controversial relative to a role in protection or eradication of infection. While studies of mucosal innate resistance are limited, we recently found that epithelial cells from saliva and vaginal lavages of healthy individuals inhibit the growth of Candida in vitro. This epithelial cell anti-Candida activity requires cell contact by viable cells with no role for soluble factors, including saliva. Interestingly, oral epithelial cells from HIV+ persons with OPC had significantly reduced activity, indicating some protective role for the epithelial cells. Taken together, these data suggest that immunity to Candida is site-specific, compartmentalized and involves innate and/or acquired mechanisms from systemic and/or local sources.

Publication Types:

Review

Review, Tutorial

PMID: 12164664 [PubMed - indexed for MEDLINE]

Med Hypotheses. 1995 Jun;44(6):507-15. Related Articles, Links

Chronic intestinal candidiasis as a possible etiological factor in the chronic fatigue syndrome.

Cater RE 2nd.

The chronic candidiasis syndrome, also known as the Candida-related complex, putatively caused by the overgrowth of Candida albicans in the gastrointestinal tract and secondarily in the genital organs, is briefly described. Patients with this disorder have many of the same symptoms as those with the chronic fatigue syndrome, except for the recurrent flu-like symptoms of the latter disorder. The positive response of a large number of patients with the chronic fatigue syndrome (CFS) to an oral antifungal agent and a diet for intestinal candidiasis has been described by another clinician. There is evidence that Candida albicans infection of the mucous membranes depresses T cell and natural killer (NK) cell function. Similar abnormalities of immune function are found in the CFS. The function of cytotoxic T cells, T helper cells, and NK cells is important in preventing reactivation of infections from Epstein-Barr virus, cytomegalovirus, and other herpesviruses. Reactivation of one or more of these viruses could lead to the expression of the flu-like symptoms in the CFS. Yet the immune dysfunction found in this disorder has been considered the primary underlying causal factor. It is proposed that chronic intestinal candidiasis may be an agent which leads to immune depression in many CFS patients and therefore that it could be a causal factor in CFS.

PMID: 7476598 [PubMed - indexed for MEDLINE]

Lett Appl Microbiol. 2002;35(2):136-40. Related Articles, Links

Dietary influence of kefir on microbial activities in the mouse bowel.

Marquina D, Santos A, Corpas I, Munoz J, Zazo J, Peinado JM.

Department of Microbiology III, Biology Faculty, Complutense University of Madrid, Madrid, Spain. dommarq@bio.ucm.es

AIMS: In this work the microflora present in kefir, a fermented milk product, was studied together with the effect of kefir administration on different groups of indigenous bacteria of mouse bowel. METHODS AND RESULTS: Kefir microflora was composed of lactic acid bacteria, acetic acid bacteria and yeasts. Yeast population was composed of Saccharomyces cerevisiae, S. unisporus, Candida kefir, Kluyveromyces marxianus and K. lactis. The streptococci levels in kefir treated mice increased by 10-fold and the levels of sulfite-reducing clostridia decreased by 100-fold. The number of lactic acid bacteria increased significantly. CONCLUSIONS: The administration of kefir significantly increased the lactic acid bacteria counts in the mucosa of the bowel. Ingestion of kefir specifically lowered microbial populations of Enterobacteriaceae and clostridia. SIGNIFICANCE AND IMPACT OF THE STUDY: This is the first long-term study about the effects of the kefir administration on the intestinal microflora of mice.

PMID: 12100589 [PubMed - indexed for MEDLINE]

Mycoses. 2001 Nov;44(9-10):375-8. Related Articles, Links

Antifungal activity of propolis on different species of Candida.

Ota C, Unterkircher C, Fantinato V, Shimizu MT.

Dental School, UNESP, Sao Jose dos Campos, SP, Brasil.

Propolis is a resinous material collected by bees from the buds or other parts of plants. It is known for its biological properties, having antibacterial, antifungal and healing properties. The antifungal activity of propolis was studied in sensitivity tests on 80 strains of Candida yeasts: 20 strains of Candida albicans, 20 strains of Candida tropicalis, 20 strains of Candida krusei and 15 strains of Candida guilliermondii. The yeasts showed a clear antifungal activity with the following order of sensitivity: C. albicans > C. tropicalis > C. krusei > C. guilliermondii. Patients with full dentures who used a hydroalcoholic propolis extract showed a decrease in the number of Candida.

PMID: 11766101 [PubMed - indexed for MEDLINE]

Sidahora. 1995 Winter;:40-1. Related Articles, Links

[Natural remedies for vaginal infections]

[Article in Spanish]

Genet J.

AIDS: Vaginal infections, affecting half of all women, are more severe in women with AIDS. The infection vulva vaginitis, caused by candida, may require medical attention. The doctor performs a pelvic exam and examines vaginal fluids under a microscope. Antibiotics, diet, or a suppressed immune system can increase candida yeast presence. Sweets should be avoided, as well as foods high in leavening, such as bread, cheese, fruit, or alcoholic beverages. Vegetables, grains, rice and wheat can be added to the diet. Eating a half-cup of yogurt daily will help maintain a proper level of yeast. Acidophilus capsules can be taken two or three times daily to relieve digestive problems. Raw or cooked garlic can be used as a vaginal suppository at night. Pau D'arco, the bark of a South American tree, is also anti-yeast. Boil for ten to twenty minutes, and take a teaspoon two or three times a day. Tea, or vinegar and water, can be used as a douche. Some women get relief by adding a half-cup of white vinegar to their bath. Do not wash genitals with soap and do not use sanitary napkins or tampons. Visit a doctor if the condition persists.

Publication Types:

Newspaper Article

PMID: 11362438 [PubMed - indexed for MEDLINE]

J Ethnopharmacol. 2000 Aug;71(3):377-82. Related Articles, Links

Anti-microbial activity of a new vaginal contraceptive NIM-76 from neem oil (Azadirachta indica).

SaiRam M, Ilavazhagan G, Sharma SK, Dhanraj SA, Suresh B, Parida MM, Jana AM, Devendra K, Selvamurthy W.

Defence Institute of Physiology and Allied Sciences, Ministry of Defence, Timarpur, -1 10054, Delhi, India.

Efficacy of NIM-76, a spermicidal fraction from neem oil, was investigated for its antimicrobial action against certain bacteria, fungi and Polio virus as compared to whole neem oil. The NIM-76 preparation showed stronger anti-microbial activity than the whole neem oil. It inhibited growth of various pathogens tested including Escherichia coli and Kleibsiella pneumoniae which were not affected by the whole neem oil. NIM-76 also exhibited antifungal activity against Candida albicans and antiviral activity against Polio virus replication in vero cell lines. It also protected mice from systemic candidiasis as revealed by enhanced % survival and reduced colony forming units of C. albicans in various tissues. This shows that NIM-76 has a potent broad spectrum anti-microbial activity.

PMID: 10940573 [PubMed - indexed for MEDLINE]

Mycoses. 1996 Jan-Feb;39(1-2):67-70. Related Articles, Links

Fungistatic and fungicidal activity of east African medicinal plants.

Fabry W, Okemo P, Ansorg R.

Institute of Medical Microbiology, University of Essen, Germany.

Extracts of the traditionally used medicinal plants Entada abyssinica (stem bark), Terminalia spinosa (young branches), Harrisonia abyssinica (roots), Ximenia caffra (roots), Azadirachta indica (stem bark), Zanha africana (stem bark) and Spilanthes mauritiana (roots and flowers) were investigated for fungistatic and fungicidal activity against Candida spp. and Aspergillus spp. by a microtitre serial dilution technique. Entada abyssinica, T. spinosa, X. caffra, A. indica, and Z. africana showed activity against various Candida species. The minimum inhibitory concentrations (MICs) ranged from 0.006 to > 8 mg ml-1 and the minimum fungicidal concentrations (MFCs) from 0.06 to > 8 mg ml-1. Extracts from S. mauritiana (both roots and flowers) exhibited no activity against Candida spp., but against Aspergillus spp., the MIC and MFC values ranged from 0.13 to 0.25 mg ml-1 and from 0.13 to 1 mg ml-1 respectively. It is concluded that the extracts contain compounds with high antifungal potency.

PMID: 8786762 [PubMed - indexed for MEDLINE]

Life Sci. 2004 Oct 29;75(24):2867-78. Related Articles, Links

Clinical studies on the effect of Neem (Azadirachta indica) bark extract on gastric secretion and gastroduodenal ulcer.

Bandyopadhyay U, Biswas K, Sengupta A, Moitra P, Dutta P, Sarkar D, Debnath P, Ganguly CK, Banerjee RK.

Department of Physiology, Indian Institute of Chemical Biology, 4, Raja S. C. Mullick Road, Kolkata, 700032, India. ubandyo_1964@yahoo.com

We have shown earlier that Neem (Azadirachta indica) bark aqueous extract has potent antisecretory and antiulcer effects in animal models and has no significant adverse effect (Bandyopadhyay et al., Life Sciences, 71, 2845-2865, 2002). The objective of the present study was to investigate whether Neem bark extract had similar antisecretory and antiulcer effects in human subjects. For this purpose, a group of patients suffering from acid-related problems and gastroduodenal ulcers were orally treated with the aqueous extract of Neem bark. The lyophilised powder of the extract when administered for 10 days at the dose of 30 mg twice daily caused a significant (p < 0.002) decrease (77%) in gastric acid secretion. The volume of gastric secretion and its pepsin activity were also inhibited by 63% and 50%, respectively. Some important blood parameters for organ toxicity such as sugar, urea, creatinine, serum glutamate oxaloacetate transaminase, serum glutamate pyruvate transaminase, albumin, globulin, hemoglobin levels and erythrocyte sedimentation rate remained close to the control values. The bark extract when taken at the dose of 30-60 mg twice daily for 10 weeks almost completely healed the duodenal ulcers monitored by barium meal X-ray or by endoscopy. One case of esophageal ulcer (gastroesophageal reflux disease) and one case of gastric ulcer also healed completely when treated at the dose of 30 mg twice daily for 6 weeks. The levels of various blood parameters for organ toxicity after Neem treatment at the doses mentioned above remained more or less close to the normal values suggesting no significant adverse effects. Neem bark extract thus has therapeutic potential for controlling gastric hypersecretion and gastroesophageal and gastroduodenal ulcers.

Publication Types:

Clinical Trial

PMID: 15454339 [PubMed - indexed for MEDLINE]

Indian J Biochem Biophys. 1994 Oct;31(5):427-9. Related Articles, Links

Effect of experimental selenium deficiency and its supplementation on the candidacidal activity of neutrophils in albino rats.

Kukreja R, Khan A.

Department of Biochemistry, Nagpur University.

The role of selenium in the diet of rats has been examined with respect to the neutrophil functions. Feeding of Se-deficient diet for 75 days resulted in reduction in candidacidal activity, superoxide production, oxygen consumption, glucose utilisation and glutathione peroxidase activity. Supplementing the diet with Se for 30 days resulted in partial restoration of all the activities.

PMID: 7851945 [PubMed - indexed for MEDLINE]

Ann Intern Med. 1992 Mar 1;116(5):353-7. Related Articles, Links

Comment in:

Ann Intern Med. 1992 Aug 15;117(4):345-6.

Ann Intern Med. 1992 Mar 1;116(5):419-20.

Ingestion of yogurt containing Lactobacillus acidophilus as prophylaxis for candidal vaginitis.

Hilton E, Isenberg HD, Alperstein P, France K, Borenstein MT.

Division of Infectious Diseases, Long Island Jewish Medical Center, New Hyde Park, NY 11042.

OBJECTIVE: To assess whether daily ingestion of yogurt containing Lactobacillus acidophilus prevents vulvovaginal candidal infections. DESIGN: Crossover trial for at least 1 year during which patients were examined for candidal infections and colonizations while receiving either a yogurt-free or a yogurt-containing diet. Patients served as their own controls. SETTING: Ambulatory infectious disease center in a teaching hospital providing tertiary care. PATIENTS: Thirty-three women with recurrent candidal vaginitis were eligible after recruitment from community practices and clinics and through advertising. Twelve patients were eliminated for protocol violations. Of the remaining 21 patients, 8 who were assigned to the yogurt arm initially refused to enter the control phase 6 months later. Thus, 13 patients completed the protocol. INTERVENTIONS: Women ate yogurt for 6 months of the study period. MEASUREMENTS: Colonization of lactobacilli and candida in the vagina and rectum; candidal infections of the vagina. MAIN RESULTS: Thirty-three eligible patients were studied. A threefold decrease in infections was seen when patients consumed yogurt containing Lactobacillus acidophilus. The mean (+/- SD) number of infections per 6 months was 2.54 +/- 1.66 in the control arm and 0.38 +/- 0.51 per 6 months in the yogurt arm (P = 0.001). Candidal colonization decreased from a mean of 3.23 +/- 2.17 per 6 months in the control arm to 0.84 +/- 0.90 per 6 months in the yogurt arm (P = 0.001). CONCLUSION: Daily ingestion of 8 ounces of yogurt containing Lactobacillus acidophilus decreased both candidal colonization and infection.

Publication Types:

Clinical Trial

Randomized Controlled Trial

PMID: 1736766 [PubMed - indexed for MEDLINE] Infect Immun. 1990 Jun;58(6):1514-7. Related Articles, Links

A model of sustained gastrointestinal colonization by Candida albicans in healthy adult mice.

Samonis G, Anaissie EJ, Rosenbaum B, Bodey GP.

Department of Medical Specialties, University of Texas M.D. Anderson Cancer Center, Houston 77030.

Three-month-old male Crl:CD1(ICR)BR and C3H/HeJ mice were fed chow containing Candida albicans for 14 days, while similar control mice were fed regular food. Stool cultures were done for all mice before and after administration of the special diet. Stool cultures were repeated 48 h, 1 week, and 1 and 3 months after stopping the diet for Crl:CD1(ICR)BR mice and again 5 months afterward for C3H/HeJ mice. Some animals were sacrificed at the end of the special diet, and cultures and histopathologic examination of various organs were performed. Colonization with C. albicans occurred in the Candida-fed mice, and the fungus was maintained in the gastrointestinal tract at a concentration of 10(3) to 10(4) CFU/g of stool for up to 5 months. There was no histologic evidence of organ infection with Candida spp. The fungus was not found in stool cultures or organs of mice in the control group. The results suggest that persistent gastrointestinal colonization of adult mice by C. albicans can be achieved without immunosuppression. Thus, with additional manipulations, this model could be useful for studying the role of gastrointestinal colonization by C. albicans in the development of systemic infection.

PMID: 2187800 [PubMed - indexed for MEDLINE]

J Nutr. 1983 Jan;113(1):178-83. Related Articles, Links

Dietary ascorbic acid and resistance to experimental renal candidiasis.

Rogers TJ, Adams-Burton K, Mallon M, Hafdahl B, Rivas V, Donnelly R, O'Day K.

Guinea pigs were maintained for various periods of time on low (0.5 mg/day), intermediate (20 mg/day), or high (100 and 500 mg/day) levels of dietary ascorbic acid. Animals in each experimental group were challenged with Candida albicans via cardiac injection, and the course of infection in the kidneys was assessed. The results show that the animals receiving only 0.5 mg of ascorbic acid per day were significantly more susceptible to the infection than animals maintained on any higher level of dietary ascorbic acid. The greater susceptibility of the guinea pigs in the 0.5-mg level group was evident, however, only during "early" stages of the infection (until about day 3). Guinea pigs receiving high levels of dietary ascorbic acid were no more resistant at any time after infection, or with any challenge dose, than those receiving an intermediate dietary level. Although these data suggest that vitamin C may be involved in resistance to candidiasis, tissue levels of ascorbic acid do not change significantly with time after infection. These results indicate that low levels of dietary ascorbic acid increase susceptibility to candidiasis, yet high (or "megadose") levels of dietary vitamin C do not show any effect on resistance to this microorganism.

PMID: 6822887 [PubMed - indexed for MEDLINE]

Ann Microbiol (Paris). 1982 Nov-Dec;133(3):491-501. Related Articles, Links

[Comparative effect of a single or continuous administration of "Saccharomyces boulardii" on the establishment of various strains of "candida" in the digestive tract of gnotobiotic mice]

[Article in French]

Ducluzeau R, Bensaada M.

Saccharomyces boulardii became established in the digestive tract of monoxenic mice; the number of viable cells ranged around 10(7.5) per gram faeces. This yeast was drastically eliminated from the digestive tract of gnotoxenic mice harbouring a complex flora of human origin. In monoxenic mice harbouring S. boulardii, Candida albicans became established at a level equivalent to that observed in monoxenic mice harbouring C. albicans alone. If gnotoxenic mice received a concentrated suspension of viable S. boulardii cells so as to steadily maintain a population level close to 10(9) viable cells, C. albicans then became established at a level 10 to 50 times lower than that reached by the yeast strain alone. The antagonistic effect exerted in vivo by S. boulardii was preventive and curative. It was active against C. albicans, C. krusei and C. pseudotropicalis strains, but ineffective against C. tropicalis. This antagonistic effect disappeared when S. boulardii cells were killed by heating.

PMID: 6762128 [PubMed - indexed for MEDLINE]

Versicherungsmedizin. 1996 Dec 1;48(6):215-7. Related Articles, Links

[Fungi in feces, fungi in the intestines--therapeutic consequences?]

[Article in German]

Rosch W.

Medizinischen Klinik am Krankenhaus Nordwest, Frankfurt am Main.

Yeast in stool specimen are due to transient or commensal growth in the GI tract. Only in immune deficient subjects candida albicans may grow invasively in squamous epithelium. In dermal or vaginal mycosis systemic therapy does not add benefit to local measures. Candida-induced diarrhea in hospitalized patients following chemotherapy stop after a few days of nystatin treatment. Candida hypersensitivity syndrome does not exist, antifungal diet does not eradicate yeast. Stool examination for candida is of no sense because a positive finding is seen in up to 80% of healthy persons.

Publication Types:

Review

Review, Tutorial

PMID: 9082647 [PubMed - indexed for MEDLINE]

Int J Hyg Environ Health. 2002 May;205(4):257-68. Related Articles, Links

Comment in:

Int J Hyg Environ Health. 2004 Jan;207(1):79-81.

The pathogenetic significance of intestinal Candida colonization--a systematic review from an interdisciplinary and environmental medical point of view.

Lacour M, Zunder T, Huber R, Sander A, Daschner F, Frank U.

Institute of Environmental Medicine and Hospital Epidemiology, Freiburg University Hospital, Hugstetterstr. 55, D-79106 Freiburg, Germany.

The etiological significance of intestinal Candida colonization continues to be controversial. This is a systematic review to determine the pathogenetic significance of intestinal Candida colonization. The search was essentially performed from 1990 to 12/7/2000 in Medline and the Cochrane-Library. The data source was restricted to articles in English and German. Selection criteria covered the topics "Epidemiology", "Infectious Diseases", "Candida-Syndrome" and "Therapy" and were essentially confined to in-vivo examination of immunocompetent adults. Two reviewers extracted independently data using predefined criteria. In total, 96 citations that proved suitable for use in the systematic review were found. Depending on the localization in the gastrointestinal tract, the recovery technique employed, and transport times, Candida colonization is frequently detected in healthy, immunocompetent adults (prevalence: 4-88%). None of the studies available so far furnish any evidence that nutritional factors, food additives, pollutants, anti-ovulants, other types of medication or diabetes mellitus might be predisposing factors for intestinal Candida colonization. However, therapeutic studies point to the possibility of Candida playing a role in antibiotic-associated diarrhea. On the other hand, antibiotics seem to favor bacterial dysbiosis, and this, like the direct side effects of drugs, offers a more plausible explanation for diarrhea or gastrointestinal symptoms. The role of intestinal colonization by Candida in Candida-associated vulvovaginitis and IgE-mediated disorders remains contradictory. Nevertheless, neither epidemiological nor therapeutic studies provide evidence for the existence of the so-called "Candida-syndrome" or "Candida-hypersensitivity-syndrome". At present, there are no proven treatment indications for antifungal "bowel decontamination".

Publication Types:

Review

Review, Tutorial

PMID: 12068745 [PubMed - indexed for MEDLINE]

Ann Saudi Med. 2004 Sep-Oct;24(5):350-3. Related Articles, Links

Glucose tolerance in pregnant women with vaginal candidiasis.

Kelekci S, Kelekci H, Cetin M, Inan I, Tokucoglu S.

Second Obstetrics and Gynecology Clinics, Ankara Education and Research Hospital, Ankara, Turkey. sefakelekci2003@yahoo.com

BACKGROUND: The use of traditional historic risk factors to identify gestational diabetes mellitus (GDM) will miss half of women with gestational diabetes mellitus. Our aim was to evaluate whether impaired glucose tolerance is a risk factor for vaginal candidiasis in pregnant women. PATIENTS AND METHODS: In a cross-sectional study, we compared the prevalence of impaired glucose tolerance in 64 pregnant women with vaginal candidiasis (positive microscopy) and 59 Candida-negative control subjects. Subjects underwent standardized 75-gram oral glucose tolerance testing between the 24th and 28th weeks of their pregnancies. Patients were included only if they had no known diabetes mellitus or historic risk factors for gestational diabetes mellitus, and had not been receiving antibiotic or steroid therapy. We compared glucose levels at fasting, 30 minutes, 60 minutes and 120 minutes, and perinatal and neonatal outcomes in the two groups. RESULTS: There were no statistical differences between cases and controls in demographic characteristics. Glucose concentrations were higher in pregnant women with vaginal candidiasis than in control subjects at fasting (89 vs. 84 mg/dL, P=0.021), 30 minutes (139 vs. 126 mg/dL, P=0.050), and 60 minutes (124 vs. 106 mg/dL, P= 0.018) after intake of 75 gram of glucose. The two groups did not differ in glucose level at 120 minutes after glucose administration. Gestational diabetes prevalence was 3.1% and 3.4% in the study and control group, respectively (P=0.274). CONCLUSION: The tolerance to glucose in pregnant women with vaginal candidiasis seems discretely impaired.

PMID: 15573846 [PubMed - in process]

J Infect. 2004 May;48(4):339-46. Related Articles, Links

Species distribution and influence of glycemic control on fungal infections in pregnant women with diabetes.

Nowakowska D, Kurnatowska A, Stray-Pedersen B, Wilczynski J.

Medical University of Lodz, Chair of Medical Biology and Parasitology, Kosciuszki 85, 90-436 Lodz, Poland. dnowakowska@hotmail.com

OBJECTIVES: (1) To find the distribution of species among fungal strains isolated from pregnant women with diabetes mellitus (DM), gestational diabetes (GDM) and healthy controls (CON); (2) to analyse the influence of glycemia on the prevalence of fungi in different body sites. METHODS: Mycological examinations were performed in 251 pregnant women: 119 diabetic (47 DM, and 72 GDM) and 132 controls. Samples were collected from vagina, rectum and oral cavity of all women and cultured on Sabouraud media. RESULTS: A total of 212 fungal strains were isolated, 12 fungal species were identified: 89.6% of the strains belonged to Candida gender, 10.4% to Saccharomyces, Geotrichum, Rhodotorula and Trichosporon genera. The prevalence of fungi, respectively, in vagina and rectum, was significantly higher in diabetics with poor glycemic control when stratified (<100 mg/dl, 100-120 mg/dl and >120 mg/dl) both the mean week glucose levels (MWGL) levels (p = 0.03, p = 0.03) and glycemia 90 min after breakfast (p = 0.04, 0.03). No difference was found in the prevalence of fungi and glycolised hemoglobin (HbA1). CONCLUSIONS: MWGL showed an association between glycemia and prevalence of fungi. However, no relation was found between HbA1 and fungal infections in well controlled diabetic pregnancies.

PMID: 15066336 [PubMed - indexed for MEDLINE]

Oral Surg Oral Med Oral Pathol. 1981 Jan;51(1):32-6. Related Articles, Links

Oral candidiasis: effects of antifungal therapy upon clinical signs and symptoms, salivary antibody, and mucosal adherence of Candida albicans.

Epstein JB, Pearsall NN, Truelove EL.

A human study of the effects of topical nystatin (Mycostatin) therapy of oral candidiasis showed that effects of treatment were limited to the time in which the drug was used. Two weeks of therapy resulted in significant reduction in number of organisms and marked improvement in signs and symptoms of candidiasis. The condition recurred rapidly following cessation of treatment. No change in specific anticandida antibody in saliva or in adherence of Candida albicans to mucosal epithelium (in vitro) was seen with treatment.

PMID: 7007953 [PubMed - indexed for MEDLINE]

J Food Prot. 2004 Mar;67(3):499-504. Related Articles, Links

Inhibitory activity of essential oils of garlic and onion against bacteria and yeasts.

Kim JW, Kim YS, Kyung KH.

Department of Food Science, Sejong University, Kunja-dong, Kwangjin-ku, Seoul 143-747, Korea.

The essential oils of garlic and onion and their constituent sulfides with three or more sulfur atoms were potent inhibitors of yeast growth. The minimum inhibitory concentrations of garlic oil, onion oil, diallyl trisulfide, diallyl tetrasulfide, and dimethyl trisulfide for all the yeasts tested ranged between 2 and 45 ppm. The oils and their constituent sulfides, however, were only very weakly antibacterial, showing minimum inhibitory concentrations of greater than 300 ppm for most of the bacteria tested. The antiyeast activity of garlic oil and onion oil was storage stable and was not influenced by pH. Film formation on soy sauce by Zygosaccharomyces rouxii SS1 was completely prevented for 30 days by the addition of 30 and 40 ppm of garlic oil and onion oil, respectively.

PMID: 15035364 [PubMed - indexed for MEDLINE]

J Agric Food Chem. 2002 Jul 17;50(15):4310-6. Related Articles, Links

Antimicrobial furostanol saponins from the seeds of Capsicum annuum L. var. acuminatum.

Iorizzi M, Lanzotti V, Ranalli G, De Marino S, Zollo F.

Dipartimento di Scienze e Tecnologie Agro-Alimentari, Ambientali e Microbiologiche, Universita degli Studi del Molise, Via F. De Sanctis, I-86100 Campobasso, Italy. iorizzi@unimol.it

Three new furostanol saponins named capsicoside E (1), capsicoside F (2), and capsicoside G (5) were obtained from the seeds of Capsicum annuum L. var. acuminatum along with known oligoglycosides (3, 4, and 6-10). On the basis of chemical and spectroscopic analyses, the structures of these new furostanol oligoglycosides were elucidated as 26-O-beta-D-glucopyranosyl-22-O-methyl-5alpha-furost-25(27)-en-2alpha,3beta,22xi,26-tetraol-3-O-beta-D-glucopyranosyl(1-->3)-beta-D-glucopyranosyl(1-->2)-[beta-D-glucopyranosyl(1-->3)]-beta-D-glucopyranosyl(1-->4)-beta-D-galactopyranoside (1), 26-O-beta-D-glucopyranosyl-(25R)-5alpha-furost-20(22)-en-2alpha,3beta,26-triol-3-O-beta-D-glucopyranosyl (1-->3)-beta-D-glucopyranosyl(1-->2)-[beta-D-glucopyranosyl(1-->3)]-beta-D-glucopyranosyl(1-->4)-beta-D-galactopyranoside (2), and 26-O-beta-D-gluco-pyranosyl-(25R)-5alpha-furosta-3beta,22xi,26-triol-3-O-beta-D-glucopyranosyl(1-->3)-beta-D-glucopyranosyl(1-->2)-[beta-D-glucopyranosyl(1-->3)]-beta-D-glucopyranosyl(1-->4)-beta-D-galactopyranoside (5). The isolated saponins showed higher antimicrobial activity against yeasts than against common fungi. Data indicated that the antiyeast activity was related to the combination of the oligosaccharide chain (S1, S2, or S3) with an O-methyl group at R(3) and the presence of a hydroxyl group at the C-2 position.

PMID: 12105963 [PubMed - indexed for MEDLINE]

AIDS Treat News. 1995 Jun 2;(no 224):1-4. Related Articles, Links

Diarrhea, and the experimental treatment Saccharomyces boulardii.

James JS.

AIDS: Saccharomyces boulardii (S. boulardii), a live yeast, has been shown to be a safe and useful treatment for HIV-related diarrhea. Although the mechanism of action is uncertain, researchers believe it may reduce inflammation or increase immune responses in the blood. However, the yeast may take advantage of an immune deficiency and cause a systemic infection. Other trials have studied S. boulardii for treatment or prevention of diarrhea due to various causes unrelated to HIV, such as antibiotic-associated diarrhea and Crohn's disease. Researchers found statistically significant benefit of S. boulardii in reducing diarrhea in many of these studies. At least two different S. boulardii products are available in AIDS buyers' clubs today. Laboratoires Biocodex, the French company now running clinical trials of S. boulardii, markets a lyophilized (freeze-dried) form of the yeast in Europe, South America, and Africa. Jarrow Formulas, a competitor, sells a less expensive S. boulardii product. For now, patients must rely largely on anecdotal and imprecise studies for information on how to use the treatment, since most of the clinical trials have been with HIV-negative patients. According to one buyer's club, most people start with three grams a day, and then work down to one gram a day to control the diarrhea.

Publication Types:

Newspaper Article

PMID: 11362510 [PubMed - indexed for MEDLINE]