Antifungals Interactions

Saccharomyces boulardii is a live yeast that is directly susceptible to systemic antifungals such as fluconazole, itraconazole, amphotericin B, and echinocandins, which kill the probiotic and negate its benefit. The same antifungals may be required to treat S. boulardii fungemia, a documented complication in critically ill and immunocompromised patients.

Systemic antifungals (fluconazole, itraconazole, amphotericin B, echinocandins) can kill yeast-based probiotics such as Saccharomyces boulardii, reducing their effectiveness. Bacterial probiotics like Lactobacillus and Bifidobacterium are generally unaffected by azole antifungals because their cell structures differ from fungi.