Natamycin in food and resistance to polyene antifungals
What it found
Using natamycin to preserve yoghurt and drinks may help gut Candida become resistant to polyene antifungals, the authors warn.
Resistance to natamycin has been seen in Candida in patients treated with it.
What they found
Studies in people
Resistance after treatment
Natamycin resistance has been seen in Candida living in the gut of patients after they were treated with natamycin for fungal infections.
Animal and lab studies
Resistance spreading
Resistance can pass between different Candida species and within Aspergillus fumigatus.
Other findings
Surface use on foods
Natamycin is poorly soluble and is used on the surface of cheese and sausages. The authors say this use is not of safety concern.
Soluble forms in drinks
Highly soluble natamycin-cyclodextrin inclusion complexes have been developed to protect beverages. The authors say this leads to high drug exposures that go above the safety level.
Gut Candida exposure
Eating food with natamycin mixed through it, such as yoghurt, and especially drinks and wine with the cyclodextrin complexes, leads to high natamycin levels in the gut. This means gut Candida are exposed to high amounts of the drug.
What the authors conclude
“Therefore, it cannot be denied that use of natamycin for preservation of yoghurt and beverages may foster development of resistance to polyenes in Candida spp.”
Also in their conclusions
- They say the effect of natamycin on faecal flora as a reservoir for resistance has to be examined.
- They state that it cannot be denied that use of natamycin for preservation of yoghurt and beverages may foster development of resistance to polyenes in Candida spp.
How it was done
Natamycin is used in the food industry to treat the surface of cheese and sausages, and highly soluble forms have now been developed to protect beverages. The authors are concerned this could work against the clinical usefulness of amphotericin B.
What it can’t tell you
- We summarised it from the abstract only.
- The paper does not report new laboratory or patient studies of its own.
- It cannot show how often resistance would arise from natamycin in food.
Who paid
- Authors work at
- University Medical Center Schleswig-Holstein, Germany; Tufts University School of Medicine, USA
The paper
- Title
- Does use of the polyene natamycin as a food preservative jeopardise the clinical efficacy of amphotericin B? A word of concern
- Type
- ReviewThe authors read earlier studies and describe what they found. It isn’t a new study.
- Evidence
- Studies in people · animals · lab
- Summarised from
- Abstract only
- Cite
- Dalhoff AA, Levy SB (2015). Does use of the polyene natamycin as a food preservative jeopardise the clinical efficacy of amphotericin B? A word of concern. International journal of antimicrobial agents. doi:10.1016/j.ijantimicag.2015.02.011PubMed 25862309DOI
Summary written 26 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error