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Probiotics as Antifungals in Mucosal Candidiasis
Open accessAbstract
Candidais an opportunistic pathogen that causes mucosal and deep systemic candidiasis. The emergence of drug resistance and the side effects of currently available antifungals have restricted their use as long-term prophylactic agents for candidal infections. Given this scenario, probiotics have been suggested as a useful alternative for the management of candidiasis. We analyzed the available data on the efficacy of probiotics in candidal colonization of host surfaces. A number of well-controlled studies indicate that probiotics, particularly lactobacilli, suppressCandidagrowth and biofilm development in vitro.A few clinical trials have also shown the beneficial effects of probiotics in reducing oral, vaginal, and enteric colonization byCandida; alleviation of clinical signs and symptoms; and, in some cases, reducing the incidence of invasive fungal infection in critically ill patients. Probiotics may serve in the future as a worthy ally in the battle against chronic mucosal candidal infections.
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“Probiotic Lactobacillus strains have been reported in vitro and in vivo to be beneficial for candidiasis management, including oral candidiasis.1,2”
From Aggregation and adhesion ability of various probiotic strains and Candida species: An in vitro study (2024) · cites this paper as [1]
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“Several other studies have also shown in-vivo efficacy and safety of probiotics in treatment of candidiasis and other fungal infections (Brzozowski et al. 2005; Vicariotto et al. 2012; Demirel et al. 2013; Matsubara et al. 2016; Silva et al. 2016).”
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“Indeed, different Lactobacillus and Bifido-bacterium genera species have been widely used for many decades as probiotics, as they provide a health benefit to the host by inhibiting Candida spp. growth (Chew et al. 2015; Matsubara et al. 2016; Hernãndez-Bautista et al. 2020).”
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“albicans growth and biofilm formation [17].”
BackgroundDemin, K. A., Refeld, A. G., Bogdanova, A. A., Prazdnova, E. V., Popov, I. V., Kutsevalova, O. Y., Ermakov, A. M., Bren, A. B., Rudoy, D. V., Chistyakov, V. A., et al. (2021) · Probiotics and Antimicrobial Proteins · doi:10.1007/s12602-021-09776-6 · Cited by 24
Probiotics for Oral Candidiasis: Critical Appraisal of the Evidence and a Path Forward
Archambault, L. S., & Dongari‐Bagtzoglou, A. I. (2022) · Frontiers in Oral Health · doi:10.3389/froh.2022.880746 · Cited by 20
Saccharomyces cerevisiae CNCM I-3856 as a New Therapeutic Agent Against Oropharyngeal Candidiasis
Roselletti, E., Sabbatini, S., Ballet, N., Perito, S., Pericolini, E., Blasi, E., Mosci, P., Decherf, A. C., Monari, C., & Vecchiarelli, A. (2019) · Frontiers in Microbiology · doi:10.3389/fmicb.2019.01469 · Cited by 20
Jia, L., Kosgey, J. C., Wang, J., Yang, J., Nyamao, R. M., Zhao, Y., Teng, X., Gao, L., Wabo, M. C., Vasilyeva, N. V., et al. (2020) · Food Science & Nutrition · doi:10.1002/fsn3.1770 · Cited by 24
Shan, Q., Liu, N., Wang, X., Zhu, Y., Yin, J., & Wang, J. (2022) · Journal of Animal Science and Biotechnology/Journal of animal science and biotechnology · doi:10.1186/s40104-022-00752-w · Cited by 22
“Further studies have shown that LGR-1 inhibits biofilm formation on Candida albicans strains on abiotic surfaces and Salmonella enterica serovar Typhimurium [35, 36].”
BackgroundHu, L., Zhou, P., Zhao, W., Hua, H., & Yan, Z. (2020) · Oral Diseases · doi:10.1111/odi.13293 · Cited by 19
Unveiling The Therapeutic Potential of Probiotics: A Review
Tukaram, K. S., Sopanrao, S. R., & Kacharu, L. O. (2025) · Journal of Future Foods · doi:10.1016/j.jfutfo.2025.09.011 · Cited by 19
The Potential Value of Probiotics after Dental Implant Placement
Xu, J., Chen, C., Gan, S., Liao, Y., Fu, R., Hou, C., Yang, S., Zheng, Z., & Chen, W. (2023) · Microorganisms · doi:10.3390/microorganisms11071845 · Cited by 20
Balakrishna, K., Naveena, G., & Kingston, J. J. (2026) · Archives of Microbiology · doi:10.1007/s00203-025-04701-9 · Cited by 21
“Supporting this, studies have shown that administration of heat-killed Lactobacillus species in mice conferred partial protection against Candida infection by suppressing colonization of viable Candida cells in the gastrointestinal tract (Matsubara et al. 2016).”
Vij, R., Hube, B., & Brunke, S. (2021) · Computational and Structural Biotechnology Journal · doi:10.1016/j.csbj.2021.02.003 · Cited by 15
“can decrease mucosal Candida infections (reviewed in [146]).”
BackgroundLi, G., Li, Q., Zhang, C., Yu, Q., Li, Q., Zhou, X., Yang, R., Yang, X., Liu, H., & Yang, Y. (2023) · Frontiers in Genetics · doi:10.3389/fgene.2023.1242711 · Cited by 15
“In severe hepatic insufficiency, both natural and acquired immunity are severely impaired, resulting in decreased immunity, and often accompanied by intestinal dysfunction, intestinal mucosal edema, increased permeability, impaired intestinal barrier leading to flora translocation, intestinal microorganisms can enter…”
BackgroundElsayes, S. A., EL-Attar, M. S., Elhadary, A., Aboulela, A., Essawy, M. M., & Soliman, I. S. (2024) · Journal of Prosthetic Dentistry · doi:10.1016/j.prosdent.2024.05.018 · Cited by 14
Probiotics in the management of radiation-induced oral mucositis
Li, Y., Li, Z., Zheng, S., & Xu, X. (2024) · Frontiers in Cellular and Infection Microbiology · doi:10.3389/fcimb.2024.1477143 · Cited by 17
Lactobacillus rhamnosus strains of oral and vaginal origin show strong antifungal activity in vitro
Jørgensen, M. R., Rikvold, P. D., Lichtenberg, M., Jensen, P. Ø., Kragelund, C., & Twetman, S. (2020) · Journal of Oral Microbiology · doi:10.1080/20002297.2020.1832832 · Cited by 15
“The most investigated probiotics for anti-Candida activity belong to the genera Lactobacillus and Bifidobacterium, but also Streptococcus has been proposed [12].”
BackgroundCatanoze, I. A., Cunha, B. G., Costa, G. Q., da Silva, E. V. F., Duque, C., & Guiotti, A. M. (2020) · Journal of Prosthetic Dentistry · doi:10.1016/j.prosdent.2020.10.005 · Cited by 11
Dai, P., Yang, M., Du, J., Wang, K., Chen, R., Feng, X., Chen, C., & Zhang, X. (2024) · Frontiers in Veterinary Science · doi:10.3389/fvets.2024.1418101 · Cited by 10
Rajasekharan, S. K., Angelini, L. L., Kroupitski, Y., Mwangi, E. W., Chai, Y., & Shemesh, M. (2024) · Biofilm · doi:10.1016/j.bioflm.2024.100244 · Cited by 10
A Prerequisite for Health: Probiotics
Rossoni, R. D., Ribeiro, F. D. C., de Barros, P. P., Mylonakis, E. E., & Junqueira, J. C. (2020) · Elsevier eBooks · doi:10.1016/b978-0-12-816664-2.00011-6 · Cited by 9
Short-Term Probiotic Administration Increases Fecal-Anti Candida Activity in Healthy Subjects
Angelis, M. D., Scagnolari, C., Oliva, A., Cavallari, E. N., Celani, L., Santinelli, L., Innocenti, G. P., Borrazzo, C., Ceccarelli, G., Vullo, V., et al. (2019) · Microorganisms · doi:10.3390/microorganisms7060162 · Cited by 8
“In conclusion a number of preliminary clinical studies suggested that probiotics might play a role in the reduction of Candida colonization on human mucosal surfaces, potentially reducing the risk of not only oral, vaginal and intestinal colonization, but also the incidence of invasive fungal infections [30].”
BackgroundWu, Y., Chen, J., Chen, L.-C., Chen, L., Huang, Y., & Liao, C. (2025) · Pathogens · doi:10.3390/pathogens14040308 · Cited by 7
“In a disseminated infection model in mice, yeast cells dispersed within mature biofilms have been shown to display higher virulence [2–5].”
The pathogenicity and future treatment strategies of Candida albicans
Wu, J., Jiang, C., Wang, H., Chen, T., Chen, X., & Da, W. (2026) · Frontiers in Cellular and Infection Microbiology · doi:10.3389/fcimb.2026.1752304 · Cited by 7
Rebai, Y., Wagner, L., Gnaien, M., Hammer, M. L., Kapitan, M., Niemiec, M. J., Mami, W., Mosbah, A., Messadi, E., Mardassi, H., et al. (2023) · Microorganisms · doi:10.3390/microorganisms11081929 · Cited by 8
“Several studies have focused on the antimicrobial potential of probiotic bacteria, particularly via the natural secretion of metabolites with antifungal properties [14].”
BackgroundAbramov, V. M., Kosarev, I. V., Валериевич, М. А., Priputnevich, T. V., Deryusheva, E. I., Панин, А. Н., Chikileva, I. O., Abashina, T. N., Melnikov, V. G., Сузина, Н. Е., et al. (2023) · Biomolecules · doi:10.3390/biom13121740 · Cited by 8
“Several studies have reported the anti-pathogenic potential of probiotic bacteria for the prevention and/or the treatment of OPC [32,37–41] and IC [42–49].”
BackgroundIn Vitro Inhibitory Effects and Co-Aggregation Activity of Lactobacilli on Candida albicans
Yocheva, L. D., Tserovska, L., Danguleva, A., Todorova, T., Zhelezova, G., Karaivanova, E., & Georgieva, R. (2024) · Microbiology Research · doi:10.3390/microbiolres15030104 · Cited by 6
“The obtained results in both model systems confirm the hypothesis that only elevated levels of lactic acid efficiently inhibit fungal growth [6,30,31].”
BackgroundResultChauhan, V., Kumar, A., Tripathi, S., Jha, M., Kumar, N., Poluri, K. M., & Gupta, P. (2024) · Discover Public Health · doi:10.1186/s12982-024-00274-y · Cited by 7
Seyyedi, Z. S., Kashani, H. H., Parchebafi, A., Ghayoumi, R., Lari, M. M. H., & Hosseini, E. S. (2025) · Current Research in Biotechnology · doi:10.1016/j.crbiot.2025.100340 · Cited by 6
Gümrü, B., & Akkitap, M. P. (2021) · Black Sea Journal of Health Science · doi:10.19127/bshealthscience.943993 · Cited by 7
Evaluation of the antifungal activity of Lactobacillus reuteri against Candida species
bakhshi, M., Salari, S., Almani, P. G. N., & Afshari, S. A. K. (2021) · Gene Reports · doi:10.1016/j.genrep.2021.101369 · Cited by 6
Lyasota, V., Bakhur, T. I., & Утеченко, М. В. (2020) · Ukrainian Journal of Ecology · doi:10.15421/2020_250 · Cited by 5
“, 2011), haemolytic Staphylococcus (Sikorska and Smoragiewicz, 2013), and fungi of Candida genus (Matsubara et al., 2016).”
BackgroundMicrobiological mechanisms of oral mucosal disease: oral-intestinal crosstalk and probiotic therapy
Zhou, Q., Liu, P., Chen, M., He, H., Xu, M., Xu, Q., Yu, J., Deng, Y., Yan, J., & Wen, Y. (2025) · Frontiers in Oral Health · doi:10.3389/froh.2025.1485028 · Cited by 5
“LrGG bacteria have the ability to adhere to epithelial cells, promote type 1 immune response, and through inhibiting the activation of macrophages to effectively reduce the in fl ammatory response, and promote the production of innate immune cells such as IL-10, IL-12, and TNF-α (67, 68).”
Pariano, M., Puccetti, M., Fabi, C., Nunzi, E., Balucchi, S., Perioli, L., Ricci, M., Giovagnoli, S., Garaci, E., & Romani, L. R. (2025) · Expert Review of Anti-infective Therapy · doi:10.1080/14787210.2025.2569831 · Cited by 6
“Lactobacillus strains, such as Lactobacillus rhamnosus GG , have been shown to restore microbial balance and inhibit fungal overgrowth, making them a valuable tool in preventing recurrent infections [184].”
Harnessing Probiotics to Combat Candidiasis: Mechanisms, Evidence, and Future Directions
Wright, E., Valand, N., & Girija, U. V. (2025) · Journal of Fungi · doi:10.3390/jof11110779 · Cited by 5
“Research indicates that certain probiotic strains such as Lactobacillus can suppress Candida growth and biofilm formation [77].”
The Hygienic Significance of Microbiota and Probiotics for Human Wellbeing
Todorov, S. D., Tagg, J. R., Algburi, A., Tiwari, S. K., Popov, I. V., Weeks, R. M., Mitrokhin, O. V., Kudryashov, I. A., Александрович, К. Д., & Chikindas, M. L. (2024) · Probiotics and Antimicrobial Proteins · doi:10.1007/s12602-024-10419-9 · Cited by 5
“Each strain, when used together, complements each other's action, and preparations containing all three types of lactobacilli better mimic the normal microbiota of the vagina [179].”
InfluentialAshouritoustani, R., Pinho, C., Oliveira, A. I., Barros, P., & Cruz, A. (2025) · Microorganisms · doi:10.3390/microorganisms13122883 · Cited by 4
“While conventional antifungal therapies such as nystatin and azoles remain the standard of care [14,15], their efficacy is often limited by side effects [16,17], and the emergence of drug-resistant Candida strains [18].”
Metadata
- Authors
- Matsubara, V. H., Bandara, H. M. H. N., Mayer, M. P. A., & Samaranayake, L. P.
- Affiliations
- The University of Queensland (AU)
- Venue
- Clinical Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2016-01-29
- Volume
- 62
- Issue
- 9
- Pages
- 1143-1153
- ISSN
- 1058-4838 (ISSN-L)
- 1537-6591
- OpenAlex
- W2325976755
- Cited by
- 151
- References
- 40
- Citations by year
- 2026: 12 · 2025: 15 · 2024: 16 · 2023: 13 · 2022: 18 · 2021: 15 · 2020: 20 · 2019: 13 · 2018: 12 · 2017: 11 · 2016: 6
- FWCI
- 2.16
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Clinical Infectious Diseases (publishedVersion)
- PubMed (publishedVersion)
- Explore Bristol Research (acceptedVersion, other-oa)
- HighWire Press Open Archive (submittedVersion)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
- Life Sciences › Agricultural and Biological Sciences › Food Science › Probiotics and Fermented Foods
- Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
- Keywords
- probiotics, antifungal activity, mucosal candidiasis, Candida, lactobacilli, candidal colonization, biofilm formation, oral candidiasis, vaginal candidiasis, invasive fungal infections, critically ill patients, antifungal resistance, candidiasis prophylaxis
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Antifungal Agents, Candidiasis, Female, Humans, Infant, Infant, Newborn, Lactobacillus, Middle Aged, Probiotics, Young Adult
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