in a child that had the highest baseline excretion of tartar-
ic acid (300 mmol/mol creatinine), an abnormal value that
was about 20 times the median normal value. Following
the treatment with the nystatin, the tartaric acid continued
to decrease. After 68 days, the parent began administering
only 50% of the dose to avoid running out of nystatin
completely. During that time, the tartaric acid began to
increase. When the nystatin prescription was refilled and
full doses of nystatin were administered, the tartaric acid
again decreased.
CARS Evaluations. The CARS evaluations were com-
pleted for 18 of the children, 16 males and 2 females. The
key to the CARS score scale is as follows: 15 to 30.0,
normal; 30.1 to 37.0, mild to moderate autism; 37.1 to
60, severe autism. The baseline mean and median scores
were 39.07 and 38.00, respectively, indicating that the
group as a whole was in the severe autism range. The
range in baseline scores is 30.5 to 53.5.
autism range, whereas 7 were scored in the mild to mod-
erate range. Nine of the 18 children were reevaluated
after the completion of nystatin therapy; the mean and
median scores were 34.57 and 32.50, respectively. The
mean decrease in the CARS score was statistically sig-
nificant (P=.037) using the paired t test. Improvements in
the clinical symptoms of autism that were cited by the
parents and teachers of the autistic children included
decreased hyperactivity, increased eye contact and vocal-
ization, better sleep patterns and concentration, increased
imaginative play, reduced stereotypical behaviors such
as spinning objects, and better academic performance.
Several parents reported a loss of gains made by their
child during antifungal drug therapy when the antifungal
drug therapy was stopped and elected to reinstate the
antifungal drug therapy. Some of the children have
stayed on this therapy for more than 2 years and the par-
ents report continued benefits to their child.
