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Review
. 2023 Aug:199:114969.
doi: 10.1016/j.addr.2023.114969. Epub 2023 Jun 20.

Reviving the interest in the versatile drug nystatin: A multitude of strategies to increase its potential as an effective and safe antifungal agent

Filipa Sousa  1 , Cecília Nascimento  2 , Domingos Ferreira  3 , Salette Reis  4 , Paulo Costa  5
Affiliations
Free article
Review

Reviving the interest in the versatile drug nystatin: A multitude of strategies to increase its potential as an effective and safe antifungal agent

Filipa Sousa et al. Adv Drug Deliv Rev. 2023 Aug.
Free article

Abstract

Nystatin is an antifungal molecule with a remarkable yet squandered versatility. In this review, its mechanism of action is explored, along with its extensive action spectrum and toxicity. A multitude of methodologies to tackle the drug's physical and chemical hurdles are outlined along with some proven-effective strategies to increase its activity and/or decrease its toxicity. A separate detailed section focused on micro and nanotechnology solutions addresses new drug delivery systems made of polymeric, metallic or lipid materials. Although the topical route depicts greater representativeness amongst these formulations, the intravenous, dental, oral, vaginal and inhalation routes are also mentioned. The unsuccessful previous attempts at developing parenteral formulations of nystatin or even the withdrawal of a nystatin-loaded multilamellar liposome should not divert research away from this drug. In fact, the interest in nystatin ought to be reawakened with the ongoing clinical trials on the promising nystatin-like genetically engineered derivate BSG005.

Keywords: Chemical modification; Degradation; Delivery systems; Fungal infections; Low solubility; Nanotechnology; Neglected diseases; Nystatin-like compounds; Resistance; Toxicity.

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Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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