Clobetasone butyrate with nystatin and oxytetracycline

How it works

Clobetasone butyrate exerts topical anti-inflammatory action through glucocorticoid receptors, oxytetracycline inhibits bacterial protein synthesis to provide broad antibacterial cover, and nystatin binds fungal ergosterol to kill Candida.

Prescribing in practice

• This is a short-term treatment for infected inflammatory skin conditions; prolonged or extensive use risks corticosteroid skin atrophy and promotes antibacterial resistance and sensitisation.
• The preparation may stain skin, clothing and bedding, which should be anticipated.
• Avoid the face where possible and do not use on untreated extensive bacterial or viral skin infection without the appropriate antimicrobial cover.

Monitoring

Review the affected skin clinically for response and local steroid effects, and discontinue if there is no improvement.

Counselling the patient

• Apply a thin layer to the affected area as directed and only for the period advised.
• Be aware the cream or ointment may stain fabrics.
• Seek advice if the skin does not improve or becomes more irritated.

Evidence & guidelines

Moderate-potency steroid-antimicrobial combinations are intended for short courses in infected eczema; topical antibiotic use should follow antimicrobial stewardship principles.