A comparison of nystatin cream with nystatin/triamcinolone acetonide combination cream in the treatment of candidal inflammation of the flexures

Abstract

In a multi-centre double-blind trial, 31 patients with proven bilateral candidal lesions of the flexures were treated for 14 days with nystatin cream on one side and with a combination of nystatin and triamcinolone acetonide cream on the other. Both treatments proved equally effective in terms of mycological cure and clinical improvement. There was a trend in favour of the combination preparation being preferred by both patients and physicians because of more rapid relief of symptoms.

Cutaneous candidiasis – an evidence‐based review of topical and systemic treatments to inform clinical practice

“…Nystatin demonstrated clinical cure rates compared to placebo of 76% vs. 28% ( P < 0.01), mycological cure rates of 68% vs. 16% ( P < 0.01) and complete cure rates of 100% vs. 13% . Nystatin therapy was reported similar in efficacy to topical clotrimazole 1%, 5‐fluorocytosine 10%, haloprogin 1% and nystatin–triamcinolone combination therapy and to oral nystatin therapy, while it was tested inferior to mupirocin (Table ).…”

“…Overall, 41 articles investigated topical therapy for cutaneous candidiasis including 2711 patients in 35 RCTs (LE: 1B) and seven prospective blinded or open‐label trials (LE: 2B), of which one article reported two trials in the same article (LE: 1B and 2B) (Table ). In total, 17 different single‐drug and four combination therapies were investigated including clotrimazole (12 studies, LE: 1B or 2B), nystatin (ten studies, LE: 1B or 2B), miconazole (eight studies, LE: 1B), halcinonide–neomycin–amphotericin B (three studies, LE: 1B), ciclopirox (two studies, LE: 1B and 2B), haloprogin (two studies, LE: 1B), halcinonide–neomycin–nystatin (two studies, LE: 1B), naftifine (two studies, LE: 1B), sulconazole (two studies, LE: 1B), mupirocin (two studies, LE: 1B or 2B) and a number of drugs tested in a single study (Table ). In 50% of the studies, the type of Candida was specified by microscopy and/or culture and the majority recorded C. albicans , whereas three studies also found a few patients with C. parapsilosis or C. tropicalis .…”

“…Topical nystatin 100 000 U/g applied 2–4 times daily for 6–28 days was investigated in 10 studies including cutaneous candidiasis at all body regions in infants to elderly patients (LE: 1B or 2B) (Table ).…”

“…Six studies investigated corticosteroid–antimicrobial combinations (LE: 1B) (Table ). The anti‐inflammatory properties came from topical corticosteroids and the antibacterial effect from neomycin and gentamycin.…”

“…The anti‐inflammatory properties came from topical corticosteroids and the antibacterial effect from neomycin and gentamycin. Antifungal drugs included nystatin and amphotericin B in three studies each, iodochlorhydroxyquin (clioquinol) in four studies and tolnaftate in one study . Infants to elderly treated at all body sites were included.…”