The treatment of Gut Fermentation Syndrome aka Autobrewery Syndrome

Here is a simple overview from https://www.healthline.com/health/auto-brewery-syndrome 

Auto Brewery Syndrome or Gut Fermentation Syndrome

What are the treatment options?

Auto brewery syndrome can be treated. Your doctor may recommend reducing carbohydrates in your diet. Treating an underlying condition like Crohn’s disease may help balance fungus in your gut.

Your doctor may prescribe antifungal medications. These drugs work to get rid of fungus infections that may be causing the problem in your gut. You might have to take the medications for three weeks or longer.

Antifungal drugs and other medications to help treat auto brewery syndrome include:

You’ll need to make nutritional changes to help treat auto brewery syndrome. While you’re taking antifungal medications, follow a strict diet:

The advice above is very good. However the situation is not quite that simple. Gut fermentation is caused by an overgrowth of yeast. In my case it was Saccharomyces Cerevisiae, self inflicted by ingesting 100 grams of live active brewer's yeast. But this condition can also be caused by Candida or other yeasts which ferment sugar into alcohol. If left untreated it can raise your blood alcohol level to way over the legal limit for drink driving and has actually been used successfully as a defence against drunk driving in the US. They yeast when fermenting causes farting (if in the large bowel) and burping if in the small bowel. You can tell you active the yeast is by the frequency and power of the burps and farts. The increase of decrease in these is an indicator of the effectiveness of your treatment regime. There is an extra complication for diabetics which is fascinating. The yeast when it ferments manages to produce a toxin which causes blood sugar levels to rise. We (Gordon Ritchie and Brian Bain) saw this as another type of diabetes. But actually it may be the way that type2 works. Regular type 2 we suspect is caused by a bacteria which produces a sugar raising toxin when metabolising sugar we suspect. So the good news is that we saw a possible candidate for the cause of type 2. We were shown this very obviously by the yeast. The more we burped and farted, the more our sugar went up. We realised that our fasting sugar level was being set by the level of activity of the yeast.  We then theorised that the same is true is regular (no yeast) type 2. 

So here is the heresy. It you eat carbs, then these do not put up your sugar much in type 2 (because if you eat 200 grams of carbs, your blood sugar will go up by 1 or 2 grams per 5 litres of blood - all your blood - which is 20-40mg/dl is US terms or 1-2 mmol/L in UK terms. So you are effectively storing 198 or 199 grams out of 200. So you are not lacking in storage space of storage capability. Your body is choosing to set a high sugar level due to its reaction to the toxin produced by the diabetic microbe in your gut. The order of events is this. Carbs go to sugar which is metabolised by the microbe, which produces the toxin which elevates your blood sugar. We saw this every day for months on our continuous glucose monitors whilst hearing and feeling the burps and the farts.

The bad news is that the yeast will eat the sugar in your interstitial fluid in the gut and the gut lining etc. The higher your blood sugar the more you will fart and burp. If you fast for 36 hours you will continue to burp and fart because the yeast can survive of the sugar in your system even when you eat nothing. So eating zero carb will not stop the fermentation. You have to take some kind of antifungal. You have also to stop eating mushrooms of coffee and raw seeds or raw nuts or raw broccoli or raw leaves or raw vegetables or anything which contains fungi. Everything must be cooked. For eating fungi is like taking a pro fungal which is the opposite of what you want. Also abstain from all alcohol because the yeast can tolerate a lot of alcohol and other gut flora cannot. So alcohol favours the yeast. 

The most effective medicinal treatment method is best illustrated by the following paper...

https://www.researchgate.net/publication/270850262_A_Case_Study_of_Gut_Fermentation_Syndrome_Auto-Brewery_with_Saccharomyces_cerevisiae_as_the_Causative_Organism 4. Treatment

The patient was given an oral course of fluconazole (Diflucan) 100 mg a day for three weeks followed by a three week course of Nystatin 500,000 IU 4 times a day. He also took daily Acidophilus tablets to re-colonize the gut. During this six week period, the patient followed a very strict no sugar, no carbohydrate diet and did not ingest alcohol in any form. His breath alcohol level was tested frequently throughout each day and was 0.00 from the time treatment began until 10 weeks later. Stool cultures were then repeated and returned negative. Finally, the patient was treated with a course of Tetracycline for the H. pylori.

Nystatin is fungicidal but not as powerful as the azole drugs. The azole drugs are very powerful but fungistatic, not fungicidal. So the fix is to suppress the yeast first for 2-3 weeks with an azole or other suppressor. Then whilst it is suppressed you kill it with the nystatin. If you just take the azole (fluconazole or itranconazole) it will bounce back around 4-6 weeks after you finish the course.  However if you are diabetic then azole drugs put up your blood sugar which helps the yeast. So you need to do a hell of a lot of sugar reducing exercise on a zero carb diet to keep your sugar low enough for the azoles to work effectively during the suppression period. Fluconazole is a good choice for suppression for Saccharomyces because it is slightly more specific to that yeast...

https://www.microbiologyresearch.org/docserver/fulltext/jmm/64/9/960_jmm000122.pdf?expires=1570916374&id=id&accname=guest&checksum=6C8E23FE19FA7E21A4BE495CEEF669CF 

Table 2. MICs (mg ml21) of yeasts isolated from the oral cavity of chronic kidney patients undergoing haemodialysis
Species Isolate Antifungal MIC 

Yeast Fluconazole Voriconazole Itraconazole Amphotecerin B Nystatin
C Albicans 0.125 0.03 0.03 1 0.125
C Galbrata 16 0.5 2 0.5 4
C Tropicalis 0.125 0.25 0.0625 0.0625 2
C Parapsilosis 16 1 2 0.25 4
C rugosa 8 2 0.0625 1 2
S Cerevisiae 1 0.06 0.5 0.5 4

However there are many herbal natural alternatives to azoles for suppression which work well

1. Curcumin with vitamin C
2. Oregano oil and leaf (no good, it kills just as much of the good bacteria as it does of the bad funghi)
3. Cinnamon
4. Candex and other cellulase products
5. Pure Octanoic Acid, Caprylic acid works well if you are not diabetic. It puts your sugar up if you are diabetic. If diabetic then use citric acid and mix it into warm water like a cup of lemon tea without the tea.

Curcumin and Oregano do not put your sugar up. Curcumin is boosted in power by black pepper (piperine) which causes the curcumin to be absorbed into the bloodstream. You might think that is a bad idea because we are trying to fix the gut. but it is a good idea because the yeast can accdess the sugar in the bloodstream somehow but the good bacteria in the gut cannot. So by adding piperine, you make the curcumin more fungicidal and less bactericidal. However piperine has a long half lifwe (around 10 hours). So do not take more than 10mg every 8 hours or it will wrap around upon itself and mess up your metabolism and send your sugar way up. Furthermore curcumin becomes a lot more powerful (3x-5) in the presence of vitamin C. 

The mixture of curcumin and ascorbic acid against different strains of Candida also exhibited 5- to 10-fold reduction of MIC values compared to the time that curcumin was tested alone [92]. These synergistic effects showed that curcumin in combination with different fungicide materials can significantly elicit synergistic activity to enhance the efficacy of existing antifungal strategies. - https://www.hindawi.com/journals/bmri/2014/186864/  - 

Synergistic anticandidal activity of pure polyphenol curcumin I in combination with azoles and polyenes generates reactive oxygen species leading to apoptosis.

Curcumin makes both azoles and polyenes 10-35x MORE EFFECTIVE !!! https://academic.oup.com/femsyr/article/10/5/570/602006 

Dosages:

Brain and Gordon went on 2x 100mg Itraconazole for 14 days. That suppressed the yeast very well but at the expense of putting our sugar up too much. We failed to capitalize on the suppression after the course had finished. So it bounced back after 6 weeks. We then suppressed the yeast with curcumin. However during that 6 weeks we we completely non diabetic. I did not have to do any exercise whatsoever. So we had cured our type 2 somehow, perhaps by the yeast hogging all the sugar. We only became diabetic again (in fact yeastabetic) when the yeast came back to bite us.

Brian only needed the curcumin from 2500 mg of turmeric (with 10 mg black pepper) and one 500mg vitamin C tablet morning and evening. He no longer burps and his sugar is normal. He has got rid of his yeast.

Gordon initially needed the curcumin from 2500 mg of turmeric (with 10 mg black pepper from Oxford Vitality) and one 500mg vitamin C tablet morning and evening and early afternoon. But he got the diet wrong and was eating raw chia seeds, which have mould on their shells. This prevented any cure (he thinks). He now bakes the raw chia seeds at 105 C for 120 mins before making them into a cold porridge. 

Gordon discovered the Nystatin is ineffective against gut fermentation syndrome in his case. It helped at first, but then the yeast became immune to it.

In the end the Nystatin failed because it is supplied in a 20% sugar solution. So you feed the yeast with sugar, then you try to kill it - which is daft. Aspen in Australia and Mutual Pharmaceutical in Pennsylvania make sugar free Nystatin pills - which are a way better idea - especially for diabetics. The Aspen brand is called NILSTAT. You can get it supplied to the UK by https://www.unitedpharmacies-uk.md  

Gordon tried this form . But it was no better than the sugary form.

Meds are not as safe as Herbals

The fix for Gordon came with properly packaged curcumin and CANDEX. The Oxford Vitality tablets are the best because they have no coating and release the curcumin immediately and the saccharomyces infection is in the stomach or upper GI, so it needs instant release curcumin. A slow release pill will not work. The curcumin however seems to inhibit more the kill. It is mainly fungistatic. Then 3 hours after the meal Gordon started taking CANDEX. This is a group of enzymes which give you the ability to eat the yeast rather than the yeast eating you. It is a fantastic concept. You are supposed to build up from one tablet to 2 tablets to 4 tablets during the 1st three days. Gordon did that. On day 3 at night he could feel the change in his guts. At one point Gordon was taking one CANDEX pill every 20 minutes. Then he realised after spending a fortune, that CANDEX can only take you so far. It will take you from a bad yeast infection to a mediumr yeast infection. But that is it. so it is the first stage of the process. But it will not eliminate a yeast infection. Gordon tried one pill every 20 minutes, starting 4 hours after his one meal per day.  These pills are great. No side effects and they target the predominant yeast. They attack the cell walls of all yeasts equally. So whichever yeast is giving you an overgrowth is preferentially targeted by virtue of its preponderance in your gut. So if you have a Candida overgrowth, then Candex will target that the most. Whereas if you have a Saccharomyces infection, it will target that the most. But they can only take the infection down to a lower level. They cannot remove it. So he stopped taking them after 6 weeks.

Also Candaway tablets (Cinnamon bark extract) from Nature's Best are quite effective (they stop the burping).

Alcohol must be avoided. But the yeast makes alcohol when it ferments. So what to do? Well Chemistry lessons tell us that: Acid + Alcohol = Ester + Water. So take some citric acid to remove the alcohol made by the yeast. Citric acid is lemon juice without the sugars!

Very strong garlic oil (not the extract, no solids, just liquids) helps considerably.

Following the advice of GOOPs Dr Amy Myers, Cloves are very good. As an experiment, if you leave a frying pan with some turkey in it for 24 hours it will stink. If you pit 4 cloves of garlic into the pan during the frying of the turkey and leave it 24 hours it will not stink, because the cloves kill the fungi which make it smell! Just swllow 3 cloves like a pill with your meal or afer it or before it. It stops the yeast for around 90 minutes.

Caprylic Acid (Octanoic Acid) is a good antifungal but is no good for diabetics as it puts your sugar up.

So here is the recommended regime for Gut Fermentation Syndrome. It is a bit of an epic undertaking!

FOOD

1. EAT NO RAW FOOD AT ALL. Nuts and seeds and salad all have yeast and mould. All raw food is covered in mould. Make sure everything is cooked long enough to kill all the mould on its surface. That means above 100 degrees C for long enough to raise the temperature of the food to 100 degrees C.

2. No sugar, no alcohol, no carbs, no fungi, no mushrooms at all. 

3. Eat meat Turkey is better than fresh Fish, which is better than Chicken, which is better than Veal, which is better than Lamb, which is better than Beef, which is better than Pork for diabetics (according to our continuous glucose monitors). It is all about not eating the fat and turkey has the least fat, whereas lamb has the best fat (but rather a lot of it). Eat whole cuts of meat. Do not eat mince. The more it is chopped up the more fungus it has. Eat eggs.

4. Eat the following veggies. These are all low FODMAP, low carb high protein and anti diabetic.

Food Kcals Non Fibrous Carb Protein Fibre Fat Non Fibrous Carb/Protein
Spinach 23 1.4 2.9 2.2 0.4 (0.14 Omega3 0.03 Omega6) 0.48
Pak Choi 19 1.18 1.5 1.0 0.2 0.79
Swiss Chard 19 2.1 1.8 1.6 0.2 1.16
Broccoli 34 4.4 2.8 2.6 0.4 1.6
Courgette 17 2.1 1.2 1.0 0.3 1.75
Radishes 19 2.1 0.8 1.9 0.1 2.6
Green Cabbage 25 3.5 1.3 2.5 0.1 2.7
Tomatoes 18 2.7 0.9 1.2 0.2 3.0

Spinach is by far the best veggie. Collard greens and Mustard greens are good too.

5. Eat at least half a loaf of our low carb bread and lots of butter cut with rapeseed oil every day. But make sure you roast the white chia seed first at 130 degrees C for 1 hour to kill the fungus on its skin. The bake at 220 degrees C Fan assisted for 30 minutes followed by 200 degrees C. I was reinfecting myself every day with this bread until I sterilised the white chia seed.

6. Eat one large or two medium meals per day. No snacking do not eat 3x per day - you need a large space between meals for the CANDEX to work..

7. Reinfection: Wash the cup you drink from when your brush your teeth. Wash every jug you drink from and sterilise them in the oven or with boiling water from the kettle. Clean every surface you eat or drink from. I was not washing my toothbrush water swilling mug at all. I would always burp after brushing my teeth. It thought that was down to the alkali in the toothpaste. NOPE. It was fungus in the cup.

SUPPLEMENTS

Wake up: 1x 2500 mg curcumin with 10 mg black pepper and 250 mg of vitamin C

Before meal: 1x Candaway, 500 mg citric acid in 100 ml of warm water (lemon tea without the tea) and 3 cloves

Every hour after the meal:: 1x Candaway, 500 mg citric acid in 100 ml of warm water
120 mg of vitamin C in 60 ml of warm water.

Starting 3 hours after the meal: 1x CANDEX in 100 ml of water every hour, for the first 4-6 weeks only, and 3 cloves, until the yeast infection is over and you stop burping completely.

Bed time: 1x 2500 mg curcumin with 10 mg black pepper and 80 mg of vitamin C in 50 ml of warm water and 500 mg of citric acid in 100 ml of war water

Candidase, Candex, and Enzyme yeast killers

Enzymes can cause die-off if they are being effective at killing yeast. The yeast control is usually better with enzymes than using yeast herbs or meds without enzymes. But if you are having trouble with die-off, then try adding in more proteases. Other enzymes besides proteases may help a little with die-off too.

Enzymedica has on their site and, I think, on the bottle of Candidase, that if you have discomfort with the Candidase, take more proteases (like Purify/Virastop - now called enzyme defense) to reduce or eliminate the discomfort. I asked what a good rule of thumb was, and was told about 2 strong proteases capsules to one yeast-killer capsule (so 2 Virastops for each Candidase, for example). - http://www.enzymestuff.com/rtdieoff.htm 

___________________________________

Relevant Scientific Papers...

Abstract - https://academic.oup.com/ajcp/article/150/suppl_1/S2/5102922

Introduction

Gut fermentation or auto-brewery syndrome is a relatively uncommon medical condition that presents a diagnostic and therapeutic challenge.

Case Report

Here we present a unique case of a 45-year-old obese, male, diabetic patient treated with two courses of antibiotics for deviated nasal septum and dental procedure who reported episodes of diarrhea, vomiting, edema, seizures, hallucinations, intermittent fevers, chills, slurred speech, and loss of consciousness precipitated after meals for a duration of 14 months. The patient denied alcohol consumption at any time. His blood ethanol levels, measured on multiple occasions, were elevated and corroborated by a 24-hour meal test administered in the hospital. Small bowel and fecal contents collected during the endoscopic procedures were remarkable for the growth of Saccharomyces cerevisiae from both samples. Gram stain was negative for Salmonella, Shigella, or Campylobacter. A rapid membrane enzyme immunoassay for C difficile antigen and toxins A and B was also negative. The patient responded well to oral fluconazole but relapsed after a month and needed further assessment. Microbiological studies undertaken on gastric and small bowel contents collected during the follow-up upper and lower endoscopic procedures were positive for Candida intermedia, sensitive to fluconazole (0.250 mcg/mL) and amphotericin B (0.250 mcg/mL). Bacterial cultures showed rare, positive growth for Klebsiella pneumoniae and Enterococcus faecium. The patient responded dramatically to a no-carbohydrate diet and intravenous administration of an antifungal agent through a peripherally inserted central catheter line. The patient has been asymptomatic ever since.

Summary

Auto-brewery syndrome in a setting of diabetes, obesity, and high carbohydrate intake presented with signs and symptoms of elevated serum ethanol levels. The importance of microbiological studies on carefully collected intestinal secretions is emphasized in this report, in the absence of validated diagnostic and treatment protocols in the literature.

Auto-Brewery as an Emerging Syndrome: Three Representative Case Studies

https://www.researchgate.net/publication/286061061_Auto-Brewery_as_an_Emerging_Syndrome_Three_Representative_Case_Studies

Auto-Brewery or Gut Fermentation Syndrome, also known as intestinal candidiasis, is a very rare phenomenon heretofore unstudied and underreported. Since the most recent case study of a man in Texas with the syndrome was published [1], the authors have been contacted by some forty plus patients, family members or physicians who believe the patients have Auto-Brewery Syndrome (ABS). This article details three representative case studies where the physician diagnosed ABS and laboratory findings confirmed pathologic levels of yeast in the intestinal tract. These three patients did not readily respond to conventional medications but responded in varying degrees to holistic treatments. The health histories provided by the patients, as well as follow up on the Texas patient, lead to the conclusion that Auto-Brewery Syndrome may be more of a chronic condition requiring lifestyle changes than an acute infection responding only to medication.

Conclusion
These three representative case studies as well as the follow-up on the original published patient case study from Texas contribute to the notion that Auto-Brewery Syndrome may be treated with antifungals but most often must be managed and prevented by lifestyle changes such as weight control, limiting sugar, corn syrup, and simple carbohydrates in the diet, as well as by eliminating alcohol intake and foods with high yeast and moulds such as coffee, peanuts, and corn. Environmental exposure to moulds and yeast such as grain silos, house mould, etc. must be considered as well.

https://www.hindawi.com/journals/bmri/2014/186864/ Curcumin does not affect Aspergillus. But it makes Azoles and polyenes (Amphotericin B and nystatin) 10-35x more effective!!!

The synergistic activity of curcumin with five azole and two polyene drugs including voriconazole, itraconazole, ketoconazole, miconazole, fluconazole, amphotericin B, and nystatin showed 10–35-fold reduction in the MIC values of the fungicides against 21 clinical isolates of C. albicans. The synergistic activity of curcumin with amphotericin B and fluconazole could be associated with the accumulation of ROS which will be suppressed by adding an antioxidant [85].

https://www.ncbi.nlm.nih.gov/books/NBK513346/ Gut fermentation Syndrome.

https://www.researchgate.net/publication/270850262_A_Case_Study_of_Gut_Fermentation_Syndrome_Auto-Brewery_with_Saccharomyces_cerevisiae_as_the_Causative_Organism 4. Treatment

The patient was given an oral course of fluconazole (Diflucan) 100 mg a day for three weeks followed by a three week course of Nystatin 500,000 IU 4 times a day. He also took daily Acidophilus tablets to re-colonize the gut. During this six week period, the patient followed a very strict no sugar, no carbohydrate diet and did not ingest alcohol in any form. His breath alcohol level was tested frequently throughout each day and was 0.00 from the time treatment began until 10 weeks later. Stool cultures were then repeated and returned negative. Finally, the patient was treated with a course of Tetracycline for the H. pylori.

Award: ACG Case Reports Journal Award

Award: Presidential Poster Award

Category: Functional Bowel Disease       Sub-Category: Clinical Vignettes/Case Reports

Zalmi Rahmany, BS, Natalia Lattanzio, BS, Vikaran Kadaba, BS

Richmond University Medical Center, Staten Island, NY

Abstract Body: Introduction: Auto-Brewery Syndrome (ABS), also known as Gut Fermentation Syndrome, is a rare medical condition in which ethanol is endogenously fermented via fungal overgrowth in the gut. The causative organism for our patient is Saccharomyces cervisiae. Both Ethanol and Metformin can lead to lactic acidosis. Conventional methods to treating ABS are not always successful, especially if exacerbated by comorbidities, therefore other empiric methods have been utilized.

Case: A 46-year-old male was eating dinner when he developed symptoms of progressively worsening vomiting, diarrhea, and slurring of speech. In the ED, he was given a diagnosis of acute pancreatitis secondary to alcohol intoxication, even though the patient had been abstinent of alcohol for 20-years. He has a PMH of diabetes and is compliant with his Metformin. The patient had undergone surgical and dental procedures in simultaneous weeks, and was prescribed antibiotics for both. Fungal stool cultures grew Saccharamyces cerevisiae. He was diagnosed with Auto-Brewery Syndrome (ABS), and was given a 21-day regimen of Fluconazole and probiotics, consistent with conventional approaches to treating ABS. The patient returned 2 weeks later appearing toxic, with elevated lactate and ethyl alcohol levels. He was admitted to the ICU for continuous monitoring, and the Infectious Disease team decided on an empiric approach of IV Micofungin. This treatment option had no supporting data due to the rarity of his condition alongside with his ongoing diabetes. The patient’s lactic acidosis resolved in the following days, as well as his ethyl alcohol levels stabilized, and the Micofungin successfully decreased fungal overgrowth. 

Discussion: In patients with diabetes, one of the main-stem goals is avoidance of lactic acidosis (Non-ketotic diabetic acidosis). Lactic acidosis can be fatal and originates through inhibition of the Pyruvate Dehydrogenase Complex (PDH), a primary means of generating energy from glucose. Ethanol is an inhibitor of PDH. Biguinides such as Metformin have been shown to inhibit PDH as well. Conventional methods failed at treating this patient, and an empiric method by the Infectious Disease team proved successful. We cannot rule out that his ABS could have been exacerbated by his diabetic medication. We know fermentation and Metformin utilize similar pathways, and this alone could lead to break through studies in treatment options of ABS in patients with known comorbidities.

Bacteroides thetaiotomicron - that is responsible for hunting out and degrading the yeasts we consume from our bread and beer. !! But it also causes dangerous bacteremia!

Hesperidin half life is 6 hours.

http://www.remedypublications.com/american-journal-of-clinical-microbiology-and-antimicrobials/articles/pdfs_folder/ajcm-v1-id1022.pdf Azoles are fungistatic, polyenes are fungicidal

Synergistic anticandidal activity of pure polyphenol curcumin I in combination with azoles and polyenes generates reactive oxygen species leading to apoptosis.

Curcumin makes both azoles and polyenes 10-35x MORE EFFECTIVE !!! https://academic.oup.com/femsyr/article/10/5/570/602006 

A Review on Antibacterial, Antiviral, and Antifungal Activity of Curcumin...

The mixture of curcumin and ascorbic acid against different strains of Candida also exhibited 5- to 10-fold reduction of MIC values compared to the time that curcumin was tested alone [92]. These synergistic effects showed that curcumin in combination with different fungicide materials can significantly elicit synergistic activity to enhance the efficacy of existing antifungal strategies. - https://www.hindawi.com/journals/bmri/2014/186864/  - 

https://www.drugs.com/mtm/nystatin.html. For gastrointestinal candidiasis 500,000 - 1,000,000 units 3x per day until 48 hours after clinical cure.

https://www.sciencedirect.com/science/article/pii/S0308814612001744  Abstract...
The objective of this study was to evaluate the antifungal and antioxidant activities of curcumin, ascorbic acid and the mixture of these two compounds. For the antifungal assay, the minimum inhibitory concentrations (MIC) were determined using Candida strains (ATCC and clinical isolates). Curcumin alone inhibited growth of Candida albicans yeast cells, whereas ascorbic acid did not present effects. However, when the mixture of ascorbic acid and curcumin was assayed to determine the association of the two compounds, the curcumin MIC decreased 5- to 10-fold. In the antioxidant assays, the sum of the alone activities of curcumin and ascorbic acid were lower than the activity of the two-compound mixture. This study highlights the importance of the association between two common antioxidants in foods, to improve the antifungal and antioxidant activities of curcumin (in vitro), and can be applied to Candida spp. infection and diseases associated with oxidative stress..

https://drhyman.com/blog/2010/07/23/is-hidden-fungus-making-you-ill/ Antifungal Medications

Sometimes, nutrition and supplements just aren’t enough to clear up stubborn yeast overgrowth. That’s where prescription medications can help. (viii) They’re often needed to treat more resistant cases of yeast for either the short or long term — and in some cases can be miraculous in their results.

Nystatin is the most common antifungal drug and is often used to treat thrush in babies. It is not absorbed by the intestinal tract and has no systemic effects. Unfortunately, many fungal organisms are resistant to nystatin and you may need stronger medications. I say “unfortunately” because these drugs are generally processed by the liver and occasionally can cause reversible elevation of liver function tests. They also may have serious interactions with other medications.

https://www.sciencedirect.com/science/article/abs/pii/S0003986174800111 

Successive reculturing of Saccharomyces cerevisiae on media containing increasing concentrations of nystalin led to the segregation of cell populations which are resistant to 30, 100, 200, and 300 U/ml of antibiotic. Since the crucial step in the antifungal action of nystatin is considered to be its binding with the membrane sterol, the sterol content of each resistant isolate was ascertained. Nys-30 isolates (resisstant to 30 U/ml of nystatin) were found to contain principally 5,6-dihydroergosterol, the immediate biogenetic precursor of ergosterol in the sensitive parent culture. The principle sterols of isolates resistant to successively higher concentrations of nystatin represented successively more primitive ergosterol precursors. These observations were interpreted to mean that resistance to nystatin in S. cerevisiae is not developed in a random fashion. Indeed, at the molecular level, the development of resistance involves an orderly selection for naturally occurring strains devoid of the ability to perform some of the enzymatic transformations required for the production of ergosterol

https://www.future-science.com/doi/full/10.4155/fmc.13.189 

Furthermore, natamycin, another polyene antimycotic, was shown to kill Saccharomyces cerevisiae by interacting with ergosterol but without the formation of pores and/or affecting membrane permeability [44]. Moreover, te Welscher and colleagues showed that antifungal action of natamycin is based on the inhibition of amino acid and glucose transport across the plasma membrane, due to the interaction of natamycin with ergosterol. They suggested that this mechanism of action is also applicable for the membrane-permeabilizing polyene antimycotics such as amphotericin B and nystatin [44]. Induction of ROS subsequently resulting in apoptosis was found to be an additional mode of action for amphotericin B and nystatin in fungal pathogens such as C. albicans, A. fumigatus and Cryptococcus spp. [17,22,45–48].

In contrast to azoles, the occurrence of resistance towards polyene antimycotics is a rather rare event [36,37] .

https://www.nature.com/articles/s41598-018-25154-9 Allicin was more effective against saccharomyces than against pseudomonas.

https://www.microbiologyresearch.org/docserver/fulltext/jmm/64/9/960_jmm000122.pdf?expires=1570916374&id=id&accname=guest&checksum=6C8E23FE19FA7E21A4BE495CEEF669CF 

Table 2. MICs (mg ml21) of yeasts isolated from the oral cavity of chronic kidney patients undergoing haemodialysis
Species Isolate Antifungal MIC

Yeast Fluconazole Voriconazole Itraconazole Amphotecerin B Nystatin
C Albicans 0.125 0.03 0.03 1 0.125
C Galbrata 16 0.5 2 0.5 4
C Tropicalis 0.125 0.25 0.0625 0.0625 2
C Parapsilosis 16 1 2 0.25 4
C rugosa 8 2 0.0625 1 2
S Cerevisiae 1 0.06 0.5 0.5 4