What is the best treatment approach for intertriginous skin infections in bedbound nursing home patients?

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Last updated: June 14, 2025View editorial policy

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From the Research

The best treatment approach for intertriginous skin infections in bedbound nursing home patients involves a comprehensive strategy combining topical antifungals, antibacterials, and proper skin care, as recommended by the most recent and highest quality study 1.

Key Considerations

  • For fungal infections (commonly Candida), apply clotrimazole 1% or miconazole 2% cream twice daily for 2-3 weeks, as supported by a systematic review and meta-analysis 2.
  • For bacterial infections, mupirocin 2% ointment applied three times daily for 7-10 days is effective, although the quality of evidence remains low 3.
  • In mixed infections, combination products like nystatin-triamcinolone may be used twice daily for 7-14 days, but limit steroid use to avoid skin thinning.

Prevention and Management

  • Prevention is crucial: keep skin folds clean and dry, change position every 2 hours, use moisture-wicking fabrics, and apply zinc oxide barrier cream to intact skin, as suggested by a review of intertrigo management 1.
  • Absorbent powders like miconazole powder can help maintain dryness.
  • Addressing underlying causes through proper hygiene, moisture control, and regular skin assessment is essential for effective treatment and prevention of recurrence, as emphasized by a study on intertrigo causes, prevention, and management 4.

Important Considerations

  • The incorporation of intertrigo in the ICD-11 provides a clear definition and should improve the accuracy of estimates, as noted in a recent review 1.
  • The literature demonstrates consensus among health professionals in approach, and this forms the basis for recommendations, although the quality of evidence remains low 1.

References

Research

Comparison of topical antifungal agents for oral candidiasis treatment: a systematic review and meta-analysis.

Oral surgery, oral medicine, oral pathology and oral radiology, 2022

Research

Current Prescribing Practices for Skin and Soft Tissue Infections in Nursing Homes.

Journal of the American Medical Directors Association, 2017

Research

Intertrigo: causes, prevention and management.

British journal of nursing (Mark Allen Publishing), 2020

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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