Nystatin Cream/Powder

How it works

Nystatin binds ergosterol in the fungal cell membrane, forming pores that disrupt membrane integrity and kill susceptible Candida species; it has no useful antibacterial activity.

Prescribing in practice

• It is effective only against Candida and other yeasts, not bacteria or dermatophytes, so confirm a fungal cause before relying on it and do not use it as broad antimicrobial cover.
• The powder is useful for moist skin folds and macerated areas while the cream suits drier intertriginous candidiasis; it is for topical use, not for systemic or deep infection.
• Negligible absorption through intact skin gives a wide safety margin, but it does not treat candidaemia or invasive fungal infection, which require systemic agents.

Monitoring

Monitor the treated skin for resolution of candidal rash and for any local irritation or sensitisation.

Counselling the patient

• This treats a yeast (thrush-type) skin infection, not bacteria.
• Keep affected skin folds clean and dry and apply as directed.
• Tell the team if the rash spreads or does not improve.

Evidence & guidelines

Topical nystatin for cutaneous candidiasis is established standard practice supported by dermatology and prescribing references.