# Randomized controlled clinical trial of the impact of combined application of rhamnosus probiotics and oral nystatin on the colonization of intestinal Candida albicans in low birth weight neonates <2,500 grams

## TL;DR

This study found that combining Rhamnosus probiotics and Nystatin reduced intestinal Candida albicans in low birth weight infants and improved feeding and hospitalization outcomes.

## Contribution

The study demonstrates the combined efficacy of Rhamnosus and Nystatin in reducing C. albicans colonization in low birth weight neonates.

## Key findings

- The intervention group had lower C. albicans stool culture positivity on day 7.
- The intervention group showed significantly improved feeding and hospitalization metrics.
- Combined Rhamnosus and Nystatin reduced hospitalization duration and NPO episodes.

## Abstract

This study aimed to evaluate the concurrent effects of consuming Rhamnosus probiotics and oral antifungal Nystatin on inhibiting Candida (C.) albicans colonization in infants weighing <2,500 grams.

This study was a randomized controlled clinical trial conducted on 104 infants born weighing <2,500 grams at Mohammad Kermanshahi Hospital in Kermanshah in 2021–22. The infants were randomly allocated into intervention (n=52) and control (n=52) groups. The control group received a placebo, 10 drops orally four times daily. In contrast, the intervention group received oral Nystatin 100,000 units 10 drops three times a day, combined with Rhamnosus Lactobacillus oral drops once daily for 7 to 10 days.

The results showed a lower frequency of positive C. albicans cultures in stool samples on the 7th day of age in the intervention group. Moreover, several variables such as the onset of nutrition, time to reach 100 ml/kg of milk intake per day, number of nil per os (NPO; “nothing through the mouth”) episodes, total NPO time during hospitalization, episodes of intolerance until discharge, and duration of hospitalization were significantly lower in the intervention group compared to the control.

The concurrent use of Rhamnosus probiotics and oral Nystatin can lead to a reduction of positive C. albicans stool culture results, average time for certain variables such as the onset of nutrition, time to reach 100 ml/kg of milk intake per day, NPO days, total NPO time during hospitalization, episodes of intolerance until discharge, and duration of hospitalization in infants weighing <2,500 grams. Hence, their simultaneous administration is recommended for these neonates.