What is the treatment for a yeast infection in a 5-year-old using nystatin (antifungal medication)?

Nystatin Treatment for Yeast Infection in a 5-Year-Old

Nystatin oral suspension at a dose of 100,000 units (1 mL) administered three times daily is the recommended treatment for oral candidiasis (thrush) in a 5-year-old child. 1

Dosing and Administration

• Nystatin oral suspension should be administered as 100,000 units (1 mL) three times daily 2, 1
• The medication should be swished around in the mouth before swallowing to ensure adequate contact with affected areas 1
• Treatment should typically continue for 7-10 days, and at least 48 hours after symptoms have resolved to prevent recurrence 2

Efficacy

• Nystatin is effective for treating localized oral candidiasis in immunocompetent children 1, 3
• The medication works by decreasing the burden of Candida in the oral cavity by direct contact with the yeast 2
• While studies show fluconazole may have higher clinical cure rates (100% vs 32% for nystatin in one study), nystatin remains a first-line option due to its safety profile and limited systemic absorption 3

Administration Tips

• For optimal efficacy, administer after meals or feeding 4
• For younger children who cannot swish and spit, the suspension can be applied directly to affected areas using a clean finger or cotton swab 2
• Ensure the medication is given after feeding/eating to maximize contact time with affected tissues 4

Monitoring and Follow-up

• Clinical improvement should be seen within 48-72 hours of starting treatment 3
• If no improvement is observed after 3-5 days, reassess the diagnosis or consider alternative antifungal therapy such as fluconazole 3, 4
• Complete the full course of treatment even if symptoms resolve earlier to prevent recurrence 2

Special Considerations

• Nystatin has minimal systemic absorption, making it a safe option for children 2
• If the infection is severe or recurrent, consider evaluation for underlying conditions that may predispose to candidiasis 2
• For persistent infections not responding to nystatin, systemic antifungals like fluconazole may be considered 3

Potential Pitfalls

• Inadequate duration of therapy is a common reason for treatment failure; ensure completion of the full course 2
• Poor adherence due to taste or frequency of administration can limit effectiveness; emphasize the importance of completing the full treatment course 4
• Concurrent use of pacifiers or bottles in younger children can lead to reinfection; these items should be sterilized regularly during treatment 2