Administration Technique for Nystatin in Infants
Nystatin suspension should be applied directly to the affected oral mucosa using a clean finger or cotton swab in young infants who cannot swish and spit, rather than simply placing it in the cheeks where it may be expelled. 1
Proper Administration Method
The key to successful nystatin treatment is ensuring adequate contact between the medication and the affected oral surfaces:
- Apply the medication directly to visible thrush lesions using a clean finger or cotton swab, rather than relying on the infant to distribute it themselves 1
- The medication works through direct contact with Candida organisms on the oral mucosa, with minimal systemic absorption 2
- Long-term contact with the oral mucosa is essential for therapeutic effect, which is why proper application technique matters 3
Why Placement Matters
Simply placing nystatin in the cheeks is problematic for several reasons:
- Young infants lack the ability to swish medication around their mouth like older children and adults can 4
- The suspension needs direct application to affected areas to achieve clinical cure 1
- Inadequate contact with lesional areas is a common reason for treatment failure 1
Standard Dosing
The recommended dose is:
- 100,000 units (1 mL) applied three to four times daily for 7-14 days 5, 4
- Treatment should continue for at least 48 hours after symptoms resolve to prevent recurrence 1
Important Caveats
Complete the full treatment course even when symptoms improve early, as inadequate duration is a frequent cause of treatment failure 1. Additionally, pacifiers and bottle nipples should be sterilized regularly during treatment to prevent reinfection 1.
For breastfeeding-associated thrush, simultaneous treatment of both mother (topical miconazole to nipples/areola) and infant is recommended 5.