Nystatin

Snapshot

• A 25-year-old woman presents to the urgent care clinic for vaginal itching and discharge. She recently completed a course of antibiotics for the treatment of urinary tract infection. On physical exam, there is white discharge with erythema and swelling of the vulva. She requests a topical agent, as she did not want to take any medications by mouth. She is instructed to use a topical cream. (Vaginal candidiasis)

Introduction

• Drugs
  • nystatin
    • topical use only
    • side effects are too toxic to be given systemically
• Mechanism of action 
  • binds to ergosterol, a key component of the cell membrane, which forms pores that allow for leakage of cellular contents
• Clinical use
  • candidiasis
    • cutaneous (intertrigo and diaper rash)
    • mucocutaneous (oral thrush and vaginal candidiasis)
• Adverse effects
  • skin irritation or hypersensitivity