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Candida infection (overgrowth) is increasing dramatically. Reports show that systemic (in the bloodstream) infections with Candida in the USA increased by up to nearly 500 per cent between 1980–89, with Candida accounting for 10 per cent of all organisms isolated from blood in hospitals.¹ The figures since then are bound to be even higher, and it is extremely important that we understand how to help the body protect itself from yeast overgrowth.

When we are ill, we have symptoms, and few symptoms are pleasant. But the symptoms are often signs that the body is fighting the actual cause of the condition. For example, if you have an infection, your temperature usually goes up, a clear sign that your immune system is fighting the infection. It is important to learn to understand symptoms and not to fight them, but to deal with the reason they are there. Another example would be the multiple symptoms of digestive distress, ranging from heartburn to bloating, constipation and/or diarrhoea. There are medications which will relieve these symptoms, although often only for a short time, but such medications will not deal with the underlying causes and often make matters worse in the long run.

There is one constant trend, even when we are unwell – that is, the body’s self-healing tendency. Your many interacting body systems (including the immune system) and functions are constantly striving for balance, for normality – a process known as homoeostasis. Cuts heal, breaks mend, infections are overcome (usually without any outside help); diarrhoea and vomiting, unpleasant as they undoubtedly are, are how the body gets rid of undesirable material from inside itself.

So the message that needs to be heard is that symptoms need to be understood so that we can learn what causes them, not what can mask them. And we need to deal with the many things we do which can aggravate and strain the defence systems of the body to allow a chance for healing and recovery.

Where infection is concerned, the ideal outcome is that the bacteria, virus or yeast is contained and overwhelmed by the homoeostatic defences of the body. Unfortunately, when your homoeostatic mechanisms have to deal with too many demands at the same time, they may not always be able to achieve that outcome. Take, for example, someone who:

1 is not getting enough essential vitamins and/or minerals in the diet, and/or

2 is eating a poor diet loaded with refined carbohydrates and sugars, and/or

3 is not getting adequate exercise, and/or

4 has picked up a viral or yeast infection which never seems to quite go away, and/or

5 is not sleeping well, or getting enough exercise, and/or

6 is under work and/or emotional stress, and/or

7 has a slight hormonal imbalance, and/or

8 has a history of antibiotic use, and/or

9 is taking the contraceptive pill.

Each of these ‘problems’ (stresses), and others, may be relatively minor and could probably be eliminated by eating more sensibly, exercising more, ensuring a better exercise and sleep pattern, doing something positive about the emotional stress, or getting advice and treatment for the hormonal, viral and yeast problems. But, if nothing is done and these various adaptive demands (and others) continue, the body’s defence and repair systems eventually become so overloaded that chronic symptoms start to appear.

And, of course, whatever emotional stress, nutritional deficiencies and acquired toxicities, and biomechanical stresses there may be (poor posture, tense muscles, poor breathing habits) that are added to this ‘load’, all are coped with in the context of the unique genetic characteristics with which each of us is born (see notes on blood types and secretor status in Chapter 1, page).

It seems that some people have inborn abilities to handle some of the ‘stress’ load more efficiently than others so that the symptoms, and their severity, that emerge from similar stress burdens will not be the same from one person to another.

What’s the solution?

One of two things needs to be done:

1 There is a need to stop and reverse the factors which are causing the adaptive demands that are overloading the body’s ability to cope;

2 There is also a need to provide help to the repair and support systems of the body to allow them to more efficiently handle the load they are coping with.

These changes need to take account of the person’s unique characteristics and personal history (including their medical history). If the right changes are made, the homoeostatic defence systems should be able to begin to work more efficiently again to detoxify, fight infection, rebuild and repair, and symptoms should gradually ease. Some of the actions needed to help in recovery from a Candida overgrowth might involve:

1 ensuring optimal nutrition (removing tasty toxins and increasing nutritionally whole foods), and/or

2 a need to learn to handle stress differently, and/or

3 taking specific action to deactivate yeasts or other organisms, and/or

4 rebalancing hormonal status and the chemistry of the body (such as vitamins, minerals, trace elements, amino acids), and/or

5 detoxification of the system, particularly the liver, and/or

6 helping to heal the lining of the intestines, which may have been damaged by overgrowth of yeast, and/or

7 whatever else that may be needed to help reduce the adaptive demands that are overloading the homoeostatic systems.

About Candida

Candida albicans is a member of the yeast family. Strictly speaking, it is a member of a subgroup of the family of organisms known as fungi (or moulds). Yeasts live virtually everywhere on the planet and can derive their nutrients from most organic sources. This means anything that is alive, or has been alive, can support yeasts – whether animal or plant. Rather than having roots like other plants, yeasts can derive their nutrients via the enzymes they produce. Given the right conditions for growth and replication, yeast is capable of almost explosive growth, as anyone who has made bread will know.

Roger Williams, Nobel prize-winning scientist, stated that if a single yeast cell is given a highly favourable environment, with a good assortment of nutrients and the correct temperature, it can, within 24 hours, produce a colony of over 100 yeast cells.² At that rate of reproduction, Williams calculated, within one week, one cell could turn into a yeast colony weighing one billion tons.

The fact that this has not happened, and is not likely to happen, is solely because the environment is seldom ideal for any creature on earth, least of all for yeast. It does, however, highlight a very pertinent point in our understanding of the Candida problem: Candida is a yeast which lives inside of you and me and, as far as is known, every other adult on earth and most children as well. It seldom takes over our entire body but, when it does, the consequences are horrific. It can only achieve such a state if the environment for it is excellent and if the defence mechanisms that the body has to control its spread are weakened or absent. This can happen, for example, in advanced immune-deficiency situations, such as in AIDS.

As Williams pointed out, in Nature, yeast cells are almost always hampered by imperfect or inadequate environmental conditions. Were it not so, they would have engulfed the earth long ago. The same fact controls the colonies of Candida (and other yeasts) that live in and on you and me.

UNINVITED RESIDENTS OF THE BODY

Candida is usually a resident of the digestive system, largely in the lower end of the intestines. It also tends to occupy sites in the vaginal regions and on the skin, without causing any symptoms when general health and immune function are good.

Research has shown that most people have antibodies to Candida. The presence of these antibodies indicates that the individual’s immune system has, at some time, been challenged to respond to the presence of the yeast. Dr Truss states that, by the age of six months at the latest, Candida is living in, or on, at least 90 per cent of people, as evidenced by a positive skin-test reaction when extracts of Candida are injected just under the skin.³ This reaction shows that there has been a previous presence of the yeast to which the body has developed defensive antibodies.

The fact that yeast lives in all of us, and yet many people sail through life with no apparent ill effects, indicates that we have learned to cope with our uninvited yeast passengers. Unlike certain other minute creatures that live in our digestive tract and which serve a useful purpose, such as Lactobacillus acidophilus (which helps in the breakdown of food and in the synthesis of some of the B vitamins), there is no symbiotic (mutually beneficial) relationship with Candida. There is no trade-off whereby a ‘room’ is given in exchange for some useful function. So Candida is a pure and simple parasite – a freeloader. This is perhaps inevitable, given the multitude of opportunistic microscopic creatures in both the animal and vegetable kingdom. Most, if not all, plants and animals enjoy similar relationships with bacteria and fungi. Some of these relationships are symbiotic and good for both parties, while others are distinctly one-sided.

So Candida, for all the musical sound of its name, is an unwelcome squatter in your body and represents a potential danger. Once we know what sort of situation removes or reduces the ability of your body’s defence systems to control it naturally, and what gives Candida the chance to proliferate, we will begin to understand what needs to be done to contain it when it gets out of hand and starts producing health problems.

It may be that we cannot actually stop yeast from taking up residence in the body, but we can certainly find ways to confine its activities to a small and relatively safe part of the premises.

The way the body defends itself

We need to understand some aspects of the body’s amazing defensive capability. It has long been observed that people who survive certain infections seldom suffer from the same disease again. This is because they develop antibodies to the infecting organism. Apart from achieving specific resistance to various disease-causing microorganisms, the immune system plays a vital role in other biological reactions. In relation to infection, we have essentially two systems of defence. One is based on the thymus gland (which lies just below the breast bone), which produces what are called T cells. Another is part of the immune system and is made up of one type of white blood cells called B cells. These protect you from most bacterial invaders and some viral infections. By producing molecules called antibodies, the B cells neutralize many potential enemies. The two systems, together making up the surveillance and protection agency of the body, work in harmony although the thymus, it is thought, takes the leading role.⁴

THE BODY’S FRONT-LINE DEFENDERS

The white blood cells, which act as the soldiers in the front line of the battle, are manufactured mainly in the marrow of the long bones of the body. Some of these are turned into T cells by the influence of hormones from the thymus gland. Other white blood cells become what are called lymphocytes. Anything that tries to get into the bloodstream or the interior of the body has to face the T and B cells, and their powerful ability to neutralize foreign substances or organisms. If a B cell senses a foreign organism, it produces antibodies that are specific to that invader. At the same time, other B cells are alerted to the alien presence, which causes them to manufacture antibodies to destroy the enemy.

It is believed that there are in excess of a million different kinds of antibodies in the bloodstream. As they are manufactured and deployed against the intruder, the lymphocytes go into action with other white blood cells to dispose of the debris and waste products of the battle between the intruder and the body. Thus, a condition such as influenza is self-limiting, with the fever and the symptoms of aching representing the intense activity going on in the body to deal with the invading virus, as well as the effects of the resulting toxicity of the breakdown products of the battle.

When T cells discover an invading organism, whether this is a virus or a fungus such as Candida (or even a mutant cancer cell), they produce substances called lymphokines, which can kill microorganisms (or cancer cells). One such lymphokine which has received much attention is interferon. Lymphokines can also call up assistance from powerful allies in this battle called macrophages, which can eliminate microorganisms and tumour cells by literally swallowing them whole. Sometimes, the T cells act as ‘helper’ cells to the B cells in their production of antibodies to fight off the invaders. They can also act as ‘suppressor’ cells to stop a defensive process from getting out of hand, when there may be a danger that the B or T cells may attack friendly tissues in the body (which is more likely to happen if the person is a non-secretor; see Chapter 1, page for a brief description of this phenomenon).

What if the immune system is inefficient?

When for any one of a number of reasons (which we will consider in a later chapter) the immune system becomes weakened, we say that the person is immunodeficient, or has a poor immune response. It is when these valiant fighters – the T and B cells – and the macrophages and their various assistants are in a weakened state that silent ‘squatters’ in the body can become free of the constraints that the defence system normally imposes and spread to areas beyond their normal limits. When this happens, a vast array of problems and symptoms can arise.

The immune defence system, with its checks and balances, may become disrupted to such an extent that the condition now known simply by the initials AIDS may occur. The initials stand for acquired immunodeficiency syndrome and, in this condition, it is the T cells (from the thymus gland) that function inadequately. Indeed, the ratio between the helper and suppressor cells becomes so altered that there is an excess of suppressor cells, in contrast to the situation in normal health. Much of the research into the treatment of immune-related conditions focuses on methods to enhance the function of the thymus gland so that it can produce a balanced and adequate supply of active T cells. Among the nutrient factors which can also achieve this are vitamin C and the amino acid arginine.

How do you ‘catch’ Candida?

The short answer is that you seldom catch or acquire yeast infections from an external source, although new strains can be introduced via sexual contact, since you have Candida all the time!

A leading medical researcher into Candida activity describes what usually happens as follows:

The most important source of Candida species in human disease is endogenous [it comes from inside you]: candidiasis arises in people who are predisposed because of illness, debility or local reduction in resistance to overgrowth of their own yeast flora.⁵

The evidence of much research is that about half the healthy population (no illness or symptoms) has Candida yeast in their mouths, easily assessed by means of a swab sample.⁶ Levels of Candida in the intestines of healthy individuals are described by researchers as ‘high’ – over 50 per cent – and, in ill people, especially where immune function is weakened, it is closer to 80 per cent.⁷ Candida in the vagina is found in approximately 20 per cent of healthy women and, when there is also vaginitis (inflamed tissues) present, the levels are much higher – around 60 per cent (but not 100 per cent as many cases of vaginitis are caused by other organisms, such as Trichomonas).⁵

So, we can see that when the immune system is in a weakened state, not only do yeast infections become more frequent, but the infecting agent may not need to be acquired from the outside, as it may quietly be biding its time in small amounts in your mouth or digestive tract, waiting for your defences to drop (due to stress, infection, dietary indiscretions or any of a host of other factors). If this happens, the ever-present, opportunistic yeast will seize the opportunity to slip through the defence barriers and advance to areas previously closed to it.

This simplistic picture of what can happen contains the essential facts. Your body is self-healing. If this self-healing ability (known as homoeostasis) is weakened or overwhelmed, organisms such as yeasts which are already inside you can spread and cause havoc.

The solution to this scenario is twofold:

1 reduce the yeast (or other invading organism) activity, and

2 improve defence and self-healing potentials.

Some consequences of yeast overgrowth

We know that before it becomes invasive, the yeast (Candida) changes from a simple yeast to an aggressive mycelial fungus. In this altered form, Candida has characteristics that make it more dangerous, including a root structure which allows it to penetrate through the mucosal barriers of, say, the digestive tract. This can lead to a variety of harmful consequences because of easier access of toxins and breakdown products of digestion directly into the bloodstream (see Chapter 4 for more detail).

Research by Dr Truss⁸ indicates that many of the toxic effects seen with Candida activity are the result of its ability to manufacture, under appropriate conditions, the substance acetaldehyde. Truss found that this well-known toxin can produce both the clinical and laboratory characteristics of Candida infection. Having analysed the amino acid profiles of affected individuals to arrive at this finding, Truss maintains that the symptoms of chronic yeast infection can be explained in terms of a toxin, which common strains of Candida have been shown to produce in the laboratory. This provides the chemical link between normal yeast fermentation and the metabolic abnormalities found in susceptible patients. Dr Truss stresses that it is highly probable that the symptoms experienced by many Candida sufferers relate directly to the ability of yeast to ferment sugar into acetaldehyde in the body.

As explained in Chapter 1, there are now tests which take advantage of this ability and which can measure any rise in blood alcohol levels after a ‘sugar loading’ in which alcohol (such as acetaldehyde) is measured after swallowing a specific amount of sugar on an empty stomach. However, this ‘gut fermentation’ test is not foolproof for a number of reasons, including the fact that other organisms, including certain bacteria which can live in the gut, can ferment sugar. But taken together with the person’s history and symptoms, it can provide a strong indication of yeast activity.

Some laboratory technicians performing these tests (and many practitioners involved in treating chronic candidiasis) report being able to smell the alcohol resulting from eating sugar in people who never drink alcohol at all. In my own experience, I have treated individuals for candidiasis who have shown high levels of alcohol in their bloodstream despite not having consumed any alcohol.

Amalgam fillings and immune suppression

There is some evidence that immune system depression can result from mercury toxicity in the body as a result of amalgam fillings in teeth.⁹ A number of researchers have shown that there are several ways in which this highly toxic metal is able to penetrate the body, with a specific, harmful effect on the immune system. There is also evidence that this can be linked to the spread of Candida activity. An increasing number of dentists are now helping affected individuals by removing mercury amalgam fillings and replacing them with either a composite or gold filling. However, it must be stressed that research into the relationship between mercury from dental fillings and health problems in general, and Candida involvement in particular, is incomplete. Yet, there is almost certainly a connection, and it is worth considering alternative choices for fillings other than amalgams that contain mercury.

The replacement of existing fillings may be required in cases where a connection can be demonstrated between a person’s health and measurable mercury toxicity. The use of supplemental amino acid compounds, such as glutathione, and of vitamin C can help to ease mercury deposits from the body. If you have a Candida problem (with or without other bacterial overgrowth or gut parasites), a clue as to whether or not mercury may be affecting you can be gathered from your answers to the following questions – as well as testing for the presence of heavy metals such as mercury in your system – involving, among other things, measuring the levels of mercury vapour in the mouth as well as analysing sweat, urine and hair (and sometimes blood) by a suitably trained physician, nutritionist, naturopath or homoeopath:

 Do you have mercury (amalgam) fillings in your teeth?

 Is your skin sensitive to contact with metals such as nickel?

 Do your symptoms include some which are regarded as involving your nervous system, perhaps associated with visual symptoms or muscular weakness or tremor?

 Do you suffer from ‘brain fog’ – poor concentration and short-term memory?

 Do you have a tendency toward allergies and food intolerances/sensitivities?

If you answer ‘yes’ to the first and to any of the other questions, then mercury in particular and/or other toxic metals (for example, cadmium and lead) may well be part of your problem, and you should consider investigating this further.¹⁰

Other factors which encourage Candida spread

Although in Chapter 3 we will look at how Candida gets out of hand, it is worth adding here some information on the most common reasons for the spread of this yeast. Hints have already been given so far about the role of sugar, and later chapters will look more closely at other dietary influences. Toxicity from mercury (and other heavy metals) has also been outlined. Other factors include:

 Age, because as we get older, immune function declines and yeast takes advantage.

 Serious illness (particularly diabetes, cancer/leukaemia, asthma (because of the treatment) and autoimmune-related diseases), where the illness itself may be associated with a declining immune efficiency (cancer, for example), or the medication used may encourage yeast to spread (steroids such as cortisone, or antibiotics).

 Use of catheters after surgical procedures or trauma, which offer yeasts easy access to the bloodstream unless hygiene is scrupulous.

 Use of inhalant medications for asthma, for example, as these usually contain steroids, which lower resistance to fungal spread.

 Following radiotherapy, as this severely lowers immune efficiency in the tissues affected.

 Low levels of stomach acids (achlorhydria), which encourages both bacterial and yeast colonization of areas where the acids would normally prevent them from going.

 Pregnancy, because of hormonal changes.

 Use of the contraceptive pill or hormone replacement therapy since these, by definition, are hormonal and alter the ecology of parts of the body, allowing Candida to spread.

 Anything which reduces the efficiency of the intestinal flora to control Candida, including prolonged stress and a diet high in fat and/or sugar and alcohol.

Denture hygiene and yeast

A further hazard related to candidiasis was discovered in a study which looked at 50 consecutive patients with respiratory disease who had all developed candidiasis in the mouth and pharynx. It was found that dentures were worn by 32 of the 50 patients and this was thought to be a major predisposing factor in the onset of Candida (among other factors encouraging Candida activity such as the use of cortisone, antibiotics and immune-suppressing sedatives). The researchers said, ‘Dentures cause tissue trauma, provide sites for [yeast] colonization and diminish salivary flow. Saliva is necessary for normal oral immune defence.’¹¹

It was found that when dentures were treated with antifungal chemicals, this helped to prevent this hazard. Regular sterilization of dentures is suggested as a safe preventative measure along with regular oral rinsing with dilute Aloe vera juice or tea tree oil (antifungal substances; see Chapter 5).

Yeast control objectives

Our ultimate attempt to neutralize and control the spread and effects of Candida (for we can seldom get rid of it completely) depends on the use of whatever safe methods we have at our disposal to remove the causes of its spread (see above) and to deprive it of its ideal nutrients while, at the same time, building up and enhancing weakened immune function. The immune system should then be able to get on with the job of keeping Candida in check by itself.

It is this double thrust of activity which must be undertaken if we are to do more than temporarily suppress Candida. The use of antifungal drugs (such as nystatin) can, it is true, destroy a great deal of Candida’s potency, and reduce symptoms resulting from its presence and activities in the body. However, the yeast activity will start again soon after the drug is stopped, especially if other changes (such as a reduced sugar intake) are not being made.

Anti-Candida protocol summary

The answer to controlling Candida in the long term (apart from reducing or removing controllable opportunities as discussed above) lies in a multipronged attack to simultaneously:

 deprive the yeast of its optimum nutrient environment (‘starve the yeast’), especially sugar-rich foods

 actively kill yeast, using safe, non-toxic methods (and sometimes standard antifungal medication, if the other aspects of the programme are carefully followed)

 actively focus on restoring the body’s normal controls over yeast by supporting the immune system and encouraging a healthy intestinal flora (‘friendly bacteria’)

 help to restore damaged tissues, such as the mucous membrane of the digestive tract (easing ‘leaky gut’ symptoms)

 support the body’s detoxification systems and organs (such as the liver) because toxic debris from dying yeast needs to be eliminated.

As we will see, there are other methods which, it is thought, can help by altering the ability of the yeast to multiply. We will consider these natural, safe alternatives to the use of drugs later.

What about antifungal drugs?

It must, however, be stated that there are conditions in which the use of antifungal drugs^12,13 can be useful, especially if the condition suggests that the process of recovery will be a very long one. In the main, however, once we learn to recognize the symptoms that indicate Candida might be getting out of hand, the natural, non-drug methods described in this book will work, and work well.

The following modern drugs are all used effectively against various Candida infections, depending on where the infection is primarily located (for instance, urinary tract, vagina, skin or systemic): fluconazole (Diflucan), itraconazole (Sporanox), ketoconazole (Nizoral), miconazole (Daktarin, Femeron), amphotericin B (Fungilin), flucytosine (Alcobon).

Side-effects: These are minimal with many of these drugs, especially if only a single dose is prescribed (which is often the case with medications such as fluconazole). The more severe reactions listed below should be seen in context as the medication would commonly be used only in cases of severe systemic candidiasis, where the person is already very ill. When the use of antifungal drugs is prolonged or repeated, the chances of side-effects increase, including:

1 nausea, headache and stomach discomfort (fluconazole, itraconazole)

2 liver dysfunction (ketoconazole, although rarely)

3 severe pruritus (itching), gastrointestinal symptoms, fever (miconazole, especially at high doses)

4 fever, headache, backache, vomiting, thrombophlebitis and, in some cases, irreversible kidney damage (amphotericin B)

5 nausea, vomiting, diarrhoea and (rarely) fatal liver disease (flucytosine).

Nystatin is one of the main antifungals used before the availability of the modern drugs listed above. Nystatin, like amphotericin B (see above) is derived from fermentation of a fungus (Streptomyces albulus or S. noursei). Nystatin is considered relatively safe and non-toxic, although Truss and others report that, once it is stopped, when Candida is apparently under control, a rebound of yeast activity can be anticipated unless a broad anti-Candida programme has been adopted.

Nystatin is effective against certain Candida strains while others are resistant. Not being a broad-spectrum antifungal agent, it allows proliferation of yeasts, such as Trichophyton, that are resistant to it while Candida is attacked. This can lead to opportunistic overgrowth of these resistant yeasts even though Candida is controlled for the short-term.¹⁴

A variety of alternatives are discussed in Chapter 5.

The unfortunate aspect of most antifungal drug treatment is that they are seldom used together with a comprehensive antifungal dietary and supplement approach, which would encourage a healthier digestive tract and immune system.

Drugs are seldom necessary at all unless the infection is severe and widespread since the methods outlined in later chapters are safer and of proven efficacy.

A reminder

Let us not lose sight of the fact that Candida lives in every one of us and usually produces no symptoms unless the environment in which it lives (our body) has been compromised.

Diagnosis of yeast involvement in health problems is not a case of establishing whether or not yeast is present – because it always is to some extent. Rather, it is the task of the healthcare provider to advise anyone with yeast-related problems to attempt to discover what underlying factors have allowed yeast to proliferate and to focus attention on these – as well as control fungal activity.

Any approach which targets the yeast alone will result in a return of symptoms sooner rather than later. It is not just the yeasts that need to be controlled, but the causes which have allowed them to opportunistically explode into action.

In Chapter 3, we will consider just what can happen to weaken your wonderful defence mechanisms as well as additional ways in which Candida is sometimes allowed to go on the rampage, and so begin to infest other areas of your body.

REFERENCES

1 Edwards J. Candida Adherence Mycology Research, Harbor–UCLA Medical Center, Montana State University, 2002

2 Williams R. Biochemical Individuality, University of Texas Press, 1979

3 Truss C. The Missing Diagnosis, Birmingham, AL: Self-published, 1980

4 Stein J (ed). Internal Medicine, London: Little Brown, 1983

5 Odds F. Candida and Candidosis, London: Balliere-Tindall, 1988

6 Epstein J. ‘Quantative relationships between Candida albicans in saliva and the clinical status of human subjects’, J Clin Microbiol 1980; 12: 475–6

7 Cohen R. ‘Fungal flora of the normal human small intestine’, N Engl J Med 1969; 280: 638–41

8 Truss CO. J Orthomolec Psychiatry 1984; 13(2): 66–93

9 Goldberg B. Chronic Fatigue, Fibromyalgia & Environmental Illness, Tiburon, CA: Future Medicine, 1998

10 Manning BR. How Safe are Mercury Fillings? Los Angeles, CA: Cancer Control Society, 1984

11 Thompson P. ‘Assessment of oral candidiasis’, BMJ 1986; vol 292

12 O’Grady F et al. Antibiotics and Chemotherapy, 7th edn, New York: Churchill Livingstone, 1997

13 Bennett J. ‘A randomized trial comparing fluconazole with amphoterecin B for treatment of candidemia’, N Engl J Med 1994; 331: 1325–30

14 Da Prato R. ‘Fatty acid ion exchange complexes in treatment of Candida albicans’, Concord, CA: report by Arteria Co., 1985

2012 UPDATE ON ANTI-FUNGAL DRUGS

There has been an increasing incidence of widespread, systemic, Candida-related infections – particularly in hospital settings.

In Europe, in 2010, approximately 50% of systemic Candida infections occurred in intensive care units. In the USA systemic fungal infections, acquired during hospitalization, increased by over 200% between 1980 and 2000.

At the same time Candida’s resistance to the most widely used drugs (such as fluconazole) has increased. Thankfully newer antifungal drugs (such as those known as echinocandins) are now available for life-threatening infections. The general advice offered throughout this book should be seen as providing preventive as well as therapeutic benefits. Quite simply – the more efficient your immune system, the less chance Candida and other yeasts will have of proliferating.