Antibiotics associated with increased risk of yeast infections

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Antibiotics and Increased Risk of Yeast Infections

Broad-Spectrum Antibiotics and Yeast Overgrowth

Broad-spectrum antibiotics, especially those with strong activity against anaerobic bacteria or high gastrointestinal concentrations, are linked to a significant increase in gastrointestinal colonization by yeasts such as Candida species. Studies in both humans and animal models show that antibiotics like ticarcillin-clavulanic acid and ceftriaxone cause a higher and more sustained rise in yeast levels compared to antibiotics with less anaerobic activity or lower GI concentrations, such as ceftazidime, aztreonam, and imipenem-cilastatin .

β-Lactam Antibiotics and Gut Mycobiota Changes

Short courses of third-generation cephalosporins (a type of β-lactam antibiotic) can significantly alter the composition of the gut fungal community, increasing both the overall fungal load and the abundance of Candida albicans. The degree of this increase varies between individuals, partly depending on their levels of endogenous fecal β-lactamase activity. This means that the same antibiotic can have different effects on yeast overgrowth in different people .

Vancomycin and Enhanced Fungal Pathogenicity

Vancomycin, commonly used to treat Staphylococcus aureus infections, has been shown to directly promote the growth and biofilm formation of Candida auris, an emerging yeast pathogen. This effect is seen both in laboratory models and in living organisms, where the presence of vancomycin increases the severity of yeast infections . Additionally, vancomycin and other antibiotics can increase the growth and virulence of several Candida species, making infections more severe .

Antibiotic-Induced Immune Dysfunction and Fungal Infections

Long-term antibiotic use can impair the immune system’s ability to fight fungal infections, particularly by disrupting lymphocyte function and reducing important antifungal immune responses in the gut. This immune dysfunction increases susceptibility to invasive candidiasis and can lead to more severe outcomes, including higher mortality rates. Vancomycin, in particular, has been shown to reduce the number of protective gut immune cells, further increasing the risk of serious fungal infections .

Clinical Evidence of Antibiotic-Related Yeast Superinfections

Large clinical studies have found that yeast and fungal superinfections can develop in hospitalized patients receiving antibiotics, although the overall frequency is relatively low. The risk is higher in patients with additional factors such as immunosuppression or impaired kidney function .

Conclusion

Multiple types of antibiotics, especially broad-spectrum agents, β-lactams, and vancomycin, are associated with an increased risk of yeast infections by promoting yeast overgrowth, enhancing fungal virulence, and impairing immune defenses. The risk and severity of these infections can vary based on the specific antibiotic used, individual patient factors, and underlying health conditions. This highlights the importance of careful antibiotic use and monitoring for fungal complications, particularly in vulnerable patient populations 123456.

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Most relevant research papers on this topic

Undesired Effect of Vancomycin Prolonged Treatment: Enhanced Biofilm Production of the Nosocomial Pathogen Candida auris

Prolonged vancomycin treatment can promote the formation of biofilms of the yeast pathogen Candida auris, potentially increasing the risk of fungal infections.

In Vitro Study

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4citations

·A. Maione et al.

Prospective evaluation of effects of broad-spectrum antibiotics on gastrointestinal yeast colonization of humans

Broad-spectrum antibiotics with anaerobic activity or high gastrointestinal concentrations can increase gastrointestinal yeast colonization in humans, similar to results in a mouse model.

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·G. Samonis et al.

A Clinical Study Provides the First Direct Evidence That Interindividual Variations in Fecal β-Lactamase Activity Affect the Gut Mycobiota Dynamics in Response to β-Lactam Antibiotics

Antibiotics increase the fungal proportion in the gut, but individual differences in fecal -lactamase activity may influence the risk of Candida albicans overgrowth.

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2022·

10citations

·Margot Delavy et al.

Long-term antibiotic exposure promotes mortality after systemic fungal infection by driving lymphocyte dysfunction and systemic escape of commensal bacteria.

Long-term antibiotic exposure increases the risk of invasive candidiasis and death after invasive candidiasis by driving lymphocyte dysfunction and systemic bacterial escape.

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69citations

·Rebecca A. Drummond et al.

β-lactam antibiotics & vancomycin increase the growth & virulence of Candida spp.

Antibiotics, particularly amoxicillin, can increase the growth and virulence of Candida species, potentially impacting the pathophysiology of invasive fungal infections in patients.

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·R. A. Aguiar Cordeiro et al.

Drug-related superinfection in hospitalized patients.

Drug-related superinfections occur in 0.7% of hospitalized patients receiving antibiotics, with yeast and fungal infections being the most common, and immunosuppression and impaired renal function increasing the risk of new infections.

Observational Study

1979·

11citations

·A. Walker et al.

International Multicentre Study of Candida auris Infections

Candida auris infections are highly resistant to most azoles and amphotericin-B, and targeted antifungal therapy and source control are key to reducing mortality.

Observational Study

2021·

32citations

·N. Pandya et al.

Invasive Candida Infections and the Harm From Antibacterial Drugs in Critically Ill Patients: Data From a Randomized, Controlled Trial to Determine the Role of Ciprofloxacin, Piperacillin-Tazobactam, Meropenem, and Cefuroxime*

High exposure to antibiotics in critically ill patients increases the risk of invasive Candida infection, particularly in those with ciprofloxacin-containing regimens.

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2015·

41citations

·J. Jensen et al.

In vitro polymyxin activity against clinical multidrug-resistant fungi

Polymyxin B and colistin show antifungal activity against most multidrug-resistant yeast and mold strains, suggesting their potential use in clinical practice to treat life-threatening fungal infections caused by MDR yeasts or molds.

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2019·

50citations

·H. Yousfi et al.

Risk factors, antifungal susceptibility, complications, and outcome of Candida auris bloodstream infection in a tertiary care center in the western region of Saudi Arabia.

Candida auris bloodstream infection is associated with long-term antibiotic use, C. auris colonization, central venous catheters, ICU admission, and immunosuppressive therapy, leading to high mortality rates.

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2023·

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·Adeeb Munshi et al.

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