Standard Dose and Duration of Nystatin Powder for Cutaneous Candidiasis
For cutaneous (skin) candidiasis, apply nystatin topical powder (100,000 units per gram) to the affected area 2-3 times daily, continuing treatment for 7-14 days or until clinical resolution. 1
Dosing Regimen
- The FDA-approved dosing for nystatin topical powder is application to the affected area 2-3 times daily 1
- The powder formulation contains 100,000 USP units per gram 1
- Treatment should continue for the full duration even if symptoms improve earlier, typically 7-14 days based on extrapolation from mucocutaneous candidiasis guidelines 2, 3
Clinical Application Strategy
- Keep the infected area dry between applications, as moisture control is critical for treatment success in cutaneous candidiasis, particularly in intertriginous areas (skin folds) 2
- The powder formulation is particularly advantageous for skin fold infections in obese and diabetic patients where moisture accumulation is problematic 2
- Apply after gently cleaning and thoroughly drying the affected area to maximize contact and efficacy 2
Duration Considerations
- Standard treatment duration is 7-14 days for most cutaneous candidiasis cases 2, 3
- Continue treatment for at least 48 hours after complete resolution of visible symptoms to prevent early relapse 4
- In immunocompromised patients, treatment duration may need to be extended beyond 14 days 3
Important Clinical Caveats
- Topical nystatin is effective for primary cutaneous candidiasis but should not be used for systemic or invasive fungal infections 2
- For paronychia (nail fold infections), the most important intervention is drainage, with nystatin serving as adjunctive therapy 2
- Topical azoles (clotrimazole, miconazole) are equally effective alternatives to nystatin for cutaneous infections 2
- If no clinical improvement is seen within 48-72 hours, consider alternative diagnoses, resistant organisms, or the need for systemic antifungal therapy 3, 5
Storage and Handling
- Store at controlled room temperature 15-30°C (59-86°F) and avoid excessive heat above 40°C (104°F) 1