[{"data":1,"prerenderedAt":157},["ShallowReactive",2],{"content-route-/en/research/nystatin-candida-systemic-symptoms-1990":3},{"state":4,"owner":4,"route":5,"locale":6,"template":7,"content":21,"projection":139,"alternates":148},"target","/en/research/nystatin-candida-systemic-symptoms-1990","en-US",{"kind":8,"family":8,"sectionKeys":9},"research-summary",[10,11,12,13,14,15,16,17,18,19,20],"bottom-line","why-source-matters","study-population","tested","results","applicability","limitations","contribution","practical-change","funding-conflicts","source",{"kind":8,"title":22,"description":23,"firstPublished":24,"evidenceAsOf":24,"lastUpdated":24,"changeNote":25,"research":26,"relations":53,"body":57},"Nystatin for presumed Candida-related systemic symptoms","A 42-woman crossover trial found no meaningful advantage over placebo for systemic or psychological symptoms.","2026-07-15","Initial draft summary created from the selected source.",{"sourceId":27,"studyType":28,"population":29,"sampleScale":30,"contribution":31,"contributionRationale":32,"relatedEvidenceMap":33,"funding":34,"conflicts":35,"paperDate":36,"results":37,"applicability":40,"limitations":45,"practicalChange":52},"dismukes-nystatin-candidiasis-hypersensitivity-1990","Randomized double-blind 32-week crossover trial of oral and vaginal nystatin and matching placebos","42 premenopausal women who met the study's then-current criteria for presumed candidiasis hypersensitivity syndrome and had a history of Candida vaginitis","42 participants in a four-regimen oral and vaginal active-treatment or placebo crossover","contradictory","The randomized placebo-controlled result directly tests a historically influential broad Candida treatment claim; a summary can separate the null systemic and psychological outcomes from the improvement in vaginal symptoms and avoid overgeneralizing beyond nystatin.","/en/research/evidence/broad-candida-claims","Critical Illness Research Foundation, NIH General Clinical Research Center grant DRR00032, and NIAID contract N01-AI-52562.","No author financial conflict statement was reported in the accessible article record.","1990-12-20",[38,39],"Mean systemic-symptom scores improved by 25% across the three nystatin-containing regimens and by 23% with all-placebo, a 2-percentage-point difference (95% confidence interval -3 to 7 percentage points).","Nystatin-containing regimens relieved vaginal symptoms more than placebo, but systemic symptoms, psychological symptoms, and global distress did not improve significantly more than placebo among the 42 participants.",{"appliesTo":41,"doesNotApplyTo":43},[42],"The tested nystatin regimens and systemic-symptom claim in the narrowly defined 1990 trial population",[44],"Every antifungal, recognized localized or invasive candidiasis, modern diagnostic criteria, or people outside the studied population",[46,49],{"finding":47,"limitation":48},"Nystatin did not outperform placebo for systemic or psychological symptoms.","The crossover trial included only 42 premenopausal women and tested nystatin under a historical syndrome definition.",{"finding":50,"limitation":51},"Vaginal symptoms improved more with active nystatin.","A localized vaginal-symptom effect does not establish that Candida caused the systemic symptoms.","No practical change. The trial does not support long-term nystatin for the tested broad systemic-symptom syndrome, while its result must not be generalized to other drugs or recognized candidiasis.",[54],{"group":55,"route":33,"label":56},"evidence","Broad Candida claims evidence map",{"type":58,"value":59,"toc":135},"minimark",[60,68,74,80,86,92,98,104,110,116,122],[61,62,64],"content-section",{"section-key":10,"title":63},"Bottom line",[65,66,67],"p",{},"Nystatin did not improve systemic or psychological symptoms meaningfully more than placebo, although it improved vaginal symptoms.",[61,69,71],{"section-key":11,"title":70},"Why this source matters",[65,72,73],{},"It directly tested a historically influential broad Candida treatment claim under blinded placebo control.",[61,75,77],{"section-key":12,"title":76},"Study and population",[65,78,79],{},"The 32-week crossover trial included 42 premenopausal women with a history of Candida vaginitis who met a historical syndrome definition.",[61,81,83],{"section-key":13,"title":82},"What was tested",[65,84,85],{},"Participants received four combinations of oral or vaginal nystatin and matching placebo, with vaginal, systemic, psychological, and overall symptoms measured.",[61,87,89],{"section-key":14,"title":88},"Results",[65,90,91],{},"Systemic symptoms improved 25% with nystatin-containing regimens and 23% with all-placebo, a 2-point difference with a 95% confidence interval from -3 to 7 points. Vaginal symptoms improved more with nystatin.",[61,93,95],{"section-key":15,"title":94},"Applicability",[65,96,97],{},"The result applies to nystatin and the trial's narrow historical population, not every antifungal or recognized localized and invasive candidiasis.",[61,99,101],{"section-key":16,"title":100},"Limitations",[65,102,103],{},"Only 42 women participated, the syndrome definition is historical, and the result cannot adjudicate other interventions.",[61,105,107],{"section-key":17,"title":106},"Contribution to the evidence",[65,108,109],{},"Contradictory. The controlled result contradicts a systemic-symptom benefit claim for nystatin while preserving the separate vaginal finding.",[61,111,113],{"section-key":18,"title":112},"Practical change",[65,114,115],{},"No practical change. This paper alone cannot change guidance, and it does not support empirical long-term nystatin for the tested broad syndrome.",[61,117,119],{"section-key":19,"title":118},"Funding and conflicts",[65,120,121],{},"Funding came from the Critical Illness Research Foundation and named NIH/NIAID support. No author financial conflict statement was reported in the accessible record.",[61,123,125],{"section-key":20,"title":124},"Source",[65,126,127,134],{},[128,129,133],"a",{"href":130,"rel":131},"https://pubmed.ncbi.nlm.nih.gov/2247104/",[132],"nofollow","Read the original publication record"," (published 20 December 1990).",{"title":136,"searchDepth":137,"depth":137,"links":138},"",2,[],{"sources":140,"claims":146,"safety":147},[141],{"sourceId":27,"title":142,"canonicalId":143,"canonicalUrl":130,"publisher":144,"sourceType":145,"publicationDate":36,"lastChecked":24},"A randomized, double-blind trial of nystatin therapy for the candidiasis hypersensitivity syndrome","PMID:2247104; DOI:10.1056/NEJM199012203232501","New England Journal of Medicine","randomized-trial",[],[],[149,152,155],{"rel":150,"hreflang":6,"href":151},"alternate","https://candipedia.org/en/research/nystatin-candida-systemic-symptoms-1990/",{"rel":150,"hreflang":153,"href":154},"pl-PL","https://candipedia.org/pl/research/nystatyna-candida-objawy-ogolne-1990/",{"rel":150,"hreflang":156,"href":151},"x-default",1784685064836]