Nystatin Cream Treatment Regimen for Cutaneous Candidiasis
For cutaneous candidiasis, apply nystatin cream (100,000 USP units per gram) to the affected area 2-3 times daily for 14 days or until 7 days after clinical resolution. 1, 2
Dosage and Administration
- Apply a thin layer of nystatin cream to clean, dry affected areas
- Frequency: 2-3 times daily 1, 2
- Duration: 14 days or until 7 days after clinical resolution 1
- For extensive infections, treatment may need to be continued longer
Application Technique
- Gently cleanse the affected area with a mild soap-free cleanser
- Thoroughly dry the area before application
- Apply a thin layer of nystatin cream to cover the affected area completely
- Allow the medication to be absorbed before covering with clothing
Patient Instructions
- Keep the affected area clean and dry
- Avoid tight-fitting clothing that may cause friction or trap moisture
- Wear light, non-constricting, absorbent cotton clothing 1
- Consider using absorptive powders like cornstarch (avoid talc) in skin folds 1
- Complete the full course of treatment even if symptoms improve quickly
Monitoring and Follow-up
- Evaluate response within 7 days of starting treatment 1
- If no improvement or worsening occurs despite appropriate therapy, consider:
- Alternative antifungal agents
- Oral antifungal therapy for extensive or resistant infections
- Ruling out other conditions or complications
Special Considerations
- For severe or extensive infections, consider adding oral fluconazole 150 mg every 72 hours for 2-3 doses 1
- Managing underlying conditions like obesity, diabetes, and immunosuppression is crucial for successful treatment 1
- HIV-infected patients may require longer courses of treatment 1
Important Caveats
- Nystatin cream is indicated only for cutaneous or mucocutaneous mycotic infections caused by Candida albicans and other susceptible Candida species 2
- This preparation is not indicated for systemic, oral, intravaginal, or ophthalmic use 2
- Store at controlled room temperature 15°-30°C (59°-86°F) and avoid excessive heat (40°C; 104°F) 2
While some studies have shown that combination products containing nystatin and corticosteroids may provide more rapid symptom relief 3, the primary treatment should focus on eradicating the fungal infection with nystatin alone, especially for initial therapy.