nystatin-a1 and Diaper-Rash

Prolonged use of topical corticosteroids causes systemic adverse effects including Cushing's syndrome and hypothalamic-pituitary-adrenal (HPA) axis suppression, which is less common than that of the oral or parenteral route. At least 43 cases with iatrogenic Cushing syndrome from very potent topical steroid usage (Clobetasol) in children and adult have been published over the last 35 years particularly in developing countries. In children group (n = 22), most are infants with diaper dermatitis and two cases who had started topical application at a very early age and died from severe disseminated CMV infection. For the adult group (n = 21), the most common purpose of steroid use was for treatment of Psoriasis. The recovery period of HPA axis suppression was 3.49 ± 2.92 and 3.84 ± 2.51 months in children and adult, respectively. We report on an 8-month-old female infant who developed Cushing's syndrome and adrenal insufficiency after diaper dermatitis treatment through the misuse of Clobetasol without doctor's prescription. Physiologic dose of hydrocortisone was prescribed to prevent an adrenal crisis for 3 months and discontinued when HPA axis recovery was confirmed by normal morning cortisol and ACTH levels.

Topics: Administration, Topical; Adrenal Cortex Hormones; Adult; Anti-Infective Agents, Local; Cushing Syndrome; Diaper Rash; Drug Combinations; Female; Gramicidin; Humans; Infant; Neomycin; Nystatin; Triamcinolone

Topics: Acne Vulgaris; Alopecia; Balanitis; Candidiasis; Dermatitis, Occupational; Dermatomycoses; Diaper Rash; Drug-Related Side Effects and Adverse Reactions; Eczema; Erectile Dysfunction; Estrogens; Female; Glucocorticoids; Griseofulvin; Humans; Keloid; Male; Nystatin; Paronychia; Psoriasis; Scabies; Sexually Transmitted Diseases; Skin Diseases; Varicose Veins; Vitamins

To assess the efficacy and clinical outcome of 2% mupirocin in a polyethylene glycol base and nystatin cream as treatment regimens in diaper candidosis.. A prospective randomized comparative study.. In vitro. The susceptibility of 20 clinical isolates of Candida albicans to 2% mupirocin, nystatin, and five additional antifungal agents was evaluated using the Nathan agar-well diffusion assay. The minimum inhibitory concentration (MIC) of mupirocin against the Candida species was determined using a tube dilution method. In vivo. Twenty patients (mean age, 12 months; range, 1 month to 4 years) with moderate to severe Monilia diaper dermatitis either had mupirocin ointment or nystatin cream applied to the infected area every 8 h or after every diaper change for a period of 7 days. Microscopic examination of skin scrapings and mycologic and microbiological cultures were performed before treatment and daily for 7 days, and progress was clinically assessed.. In vitro. Topical mupirocin produced a greater zone of inhibition than nystatin cream, i.e. a mean of 27.2 mm (SD 1.55) compared with a mean of 17.3 mm (SD 1.08) for nystatin cream. MIC for mupirocin of 512 microg/mL in one case, 256 microg/mL in six cases, 200 microg/mL in 10 cases and 400 microg/mL in three cases were obtained for the 20 clinical isolates. C. albicans also displayed a universal sensitivity to mupirocin and nystatin. In vivo. Eradication of all Candida organisms was achieved within 2-6 days (mean, 2.6 days) in 10 patients receiving topical mupirocin therapy with rapid healing of the excoriated wounds (mean, 4.7 days). Both Gram-positive and Gram-negative bacteria were eradicated from the infected area within the trial period. Ten patients received topical nystatin cream and, in each case, Candida was successfully cleared within 5 days (mean, 2.8 days). Only three wounds were clinically healed within the trial period, however. The remaining seven wounds showed evidence of improved, but ongoing excoriated dermatitis and a heavy growth of polymicrobial organisms.. Both agents eradicated Candida, the major difference being the marked response of the diaper dermatitis to mupirocin. Mupirocin should be applied topically 3-4 times daily or with each diaper change and is an excellent antifungal agent.

Topics: Administration, Topical; Anal Canal; Anti-Bacterial Agents; Antifungal Agents; Candida albicans; Candidiasis; Child, Preschool; Diaper Rash; Female; Follow-Up Studies; Humans; Infant; Infant, Newborn; Male; Microbial Sensitivity Tests; Mupirocin; Nystatin; Treatment Outcome

A double-blind trial was carried out in 62 infants with moderate to severe napkin dermatitis to assess the effectiveness and acceptability of topical treatment with a miconazole/hydrocortisone preparation compared with that of a nystatin/benzalkonium chloride/dimethicone/hydrocortisone preparation. Patients were allocated at random to one or other treatment and the creams were applied to the affected area 3-times daily for 7 days. At the initial visit, a swab was taken for microbiological investigation. Clinical assessments were made of the signs and symptoms of erythema, weeping, tissue maceration and the more general symptom irritability, before and after 7-days' treatment. Parents were asked to note the time taken to significant improvement of their infant's condition and to comment on ease of application and staining properties of the preparation used. Both treatments produced a high and similar overall cure rate (80% and 84%, respectively), with a significant improvement within 48 hours in the majority of cases. Staining of napkins was reported in significantly fewer cases with the miconazole/hydrocortisone cream.

Topics: Administration, Topical; Anti-Inflammatory Agents; Benzalkonium Compounds; Child, Preschool; Clinical Trials as Topic; Diaper Rash; Double-Blind Method; Drug Combinations; Female; Humans; Hydrocortisone; Infant; Infant, Newborn; Male; Miconazole; Nystatin; Random Allocation; Silicones; Simethicone

Topics: Administration, Oral; Administration, Topical; Candidiasis; Clinical Trials as Topic; Diaper Rash; Double-Blind Method; Humans; Infant; Nystatin; Prospective Studies; Recurrence

Topics: Benzalkonium Compounds; Candidiasis; Clinical Trials as Topic; Dermatitis, Seborrheic; Diaper Rash; Drug Combinations; Eczema; Female; Humans; Hydrocortisone; Infant; Intertrigo; Male; Nystatin; Ointments; Pruritus Ani; Pruritus Vulvae; Psoriasis; Scrotum; Silicones; Simethicone; Skin Diseases; Tinea

Topics: Anti-Bacterial Agents; Antifungal Agents; Bacitracin; Blister; Candidiasis; Cephalexin; Diagnosis, Differential; Diaper Rash; Forehead; Humans; Impetigo; Infant, Newborn; Male; Nystatin; Staphylococcal Infections; Staphylococcus aureus; Time

Topics: Cost Savings; Diaper Rash; Drug Combinations; Drug Compounding; Humans; Hydrocortisone; Nystatin; Ointments; Zinc Oxide

 To define the incidence of perianal dermatitis (PD) and determine the usage pattern and cost efficacy of diaper products among neonates admitted to a level IV neonatal intensive care unit (NICU) including those with a diagnosis of neonatal abstinence syndrome (NAS)..  A retrospective cohort study to evaluate neonates with PD based on number of orders for Aquaphor, Bagbalm, Desitin, Flanders, or Nystatin. Various demographic and clinical parameters were recorded. Usage patterns of these five products were analyzed, and their costs estimated. Subgroup analysis was performed among infants with NAS..  Of 1,241 admissions, 56.2% had at least one diaper product ordered during their NICU stay, while 52.6% had multiple products ordered. Only 23.0% of all neonates had appropriate documentation of PD. The most common product ordered first was Aquaphor (64.3%), followed by Desitin (19.2%). Note that 86% term NAS infants had PD compared with 28% term non-NAS infants. The estimated product cost was $14,139 over 2 years, averaging $20 per patient..  Over half of NICU neonates were exposed to one or more diaper products, usually without documented PD diagnosis. Term NAS infants had three times higher incidence of PD than term non-NAS infants. The cost of diaper product use was significant, and possibly underestimated due to lack of documentation.

Topics: Diaper Rash; Diapers, Infant; Female; Humans; Incidence; Infant, Newborn; Intensive Care Units, Neonatal; Male; Neonatal Abstinence Syndrome; Nystatin; Perineum; Powders; Retrospective Studies; Skin Cream; Term Birth; West Virginia

Diaper dermatitis is the most common dermatologic disorder of infancy. This study evaluates the frequency of outpatient visits resulting in this diagnosis, specialties of physicians providing services, demographics of patients, and leading agents used in treatment.. Records of 272,841 encounters from the National Ambulatory Medical Care Survey (1990-1997) were examined for visits in which diaper dermatitis was diagnosed in children. The likelihood of diagnosis in the general pediatric population was calculated and the leading treatment agents were ranked.. There were approximately 8.2 million visits in which diaper dermatitis was diagnosed. For the pediatric population in the at-risk age range, there was a 1 in 4 likelihood of being diagnosed with the skin disorder. Pediatricians provided 75% of services for the treatment of diaper dermatitis; the demographics of patients were similar to those of comparably aged individuals in the general population. Nystatin was the leading treatment agent prescribed (27% of visits), followed by clotrimazole (16%), a combination product of nystatin and triamcinolone (16%), hydrocortisone (8%), and a combination product of clotrimazole and betamethasone dipropionate (6%).. Visits for diaper dermatitis are frequent, and pediatricians are the physicians most often called on to provide treatment. No portion of the pediatric population is disproportionately diagnosed. The frequent use of potent corticosteroids contained in combination agents is a potential target for improving the management of diaper dermatitis.

Topics: Administration, Topical; Age Distribution; Ambulatory Care; Anti-Inflammatory Agents; Antifungal Agents; Betamethasone; Clotrimazole; Diaper Rash; Drug Utilization; Glucocorticoids; Health Care Surveys; Humans; Hydrocortisone; Infant; Infant, Newborn; Nystatin; Pediatrics; Risk Factors; Triamcinolone; United States

Topics: Dermatitis, Allergic Contact; Diagnosis, Differential; Diaper Rash; Drug Combinations; Epoxy Resins; Ethylenediamines; Gramicidin; Humans; Infant; Infant, Newborn; Neomycin; Nickel; Nystatin; Triamcinolone Acetonide

The concentrations of nystatin excreted with faeces during and after oral application of 3 x 150,000 IU/d, either continuously for 14-21 days or every second day were determined in 42 newborns at risk by means of a bioassay (agar diffusion test). Results indicate that nystatin is distributed heterogeneously in the gastrointestinal tract. The excretion occurs discontinuously. 24 to 48 h after beginning of therapy there were effective concentrations of nystatin in the faeces. The daily application of 3 x 150,000 IU nystatin is recommended.

Topics: Biological Availability; Candidiasis, Cutaneous; Candidiasis, Oral; Diaper Rash; Dose-Response Relationship, Drug; Drug Administration Schedule; Feces; Humans; Infant, Newborn; Infant, Premature, Diseases; Metabolic Clearance Rate; Nystatin; Risk Factors

Topics: Adolescent; Child; Child, Preschool; Dermatitis; Diaper Rash; Drug Combinations; Female; Humans; Infant; Male; Nystatin; Ointments; Zinc; Zinc Oxide

Twenty-five infants and children with Candida infections in the perianal, genital and inguinal areas and on the skin normally covered by the napkin or diaper, confirmed by culture tests and microscopy, were treated with a new combined foam preparation containing the active substances nystatin, chlorhexidine and prednisolone. Even partially very severe lesions with multiple, satellitelike colonies on the trunk, extremities and neck were, without exception, cured within a maximum of 13 days. After disappearing of the exudative stage, intermittent treatment with a rather more greasy excipient (Excipial Cream) containing no active substance, has proved beneficial.

Topics: Administration, Topical; Candidiasis, Cutaneous; Child; Child, Preschool; Chlorhexidine; Diaper Rash; Drug Combinations; Female; Humans; Infant; Infant, Newborn; Male; Nystatin; Prednisolone

Topics: Administration, Topical; Anti-Inflammatory Agents; Chlorhexidine; Diaper Rash; Drug Combinations; Female; Humans; Hydrocortisone; Infant; Male; Nystatin; Ointments

Topics: Administration, Topical; Adrenal Cortex Hormones; Anti-Inflammatory Agents; Diaper Rash; Humans; Hydrocortisone; Nystatin; Zinc Oxide

A well-defined, characteristic disease has been observed in babies at the Department of Dermatology, Innsbruck University, over the past 7 years. On account of the localisation and probable pathogenesis of the condition the term "Windelsoor" (napkin thrush) has been coined by us for it. The clinical picture, the mycological and histological findings, the therapeutic results and the follow up are reported and the aetiology and pathogenesis of this disease discussed.

Topics: Antibodies, Fungal; Antibody Formation; Antifungal Agents; Biopsy; Candida albicans; Candidiasis; Diaper Rash; Fluorescent Antibody Technique; Gentian Violet; Humans; Infant; Infant, Newborn; Male; Nystatin

Topics: Amphotericin B; Antifungal Agents; Candida albicans; Candidiasis; Candidiasis, Oral; Diaper Rash; Drug Resistance, Microbial; Female; Griseofulvin; Humans; Male; Mouth Diseases; Nystatin; Ointments; Paronychia; Pruritus Ani; Skin Diseases; Tinea; Tinea Pedis; Tinea Versicolor

Topics: Administration, Oral; Candida; Candida albicans; Diaper Rash; Feces; Humans; Infant; Infant, Newborn; Nystatin; Ointments

Topics: Candidiasis, Cutaneous; Diagnosis, Differential; Diaper Rash; Humans; Infant; Infant, Newborn; Nystatin

Topics: Candidiasis, Cutaneous; Child, Preschool; Dermatitis, Seborrheic; Diaper Rash; Eczema; Female; Humans; Nystatin; Ointments; Psoriasis; Terminology as Topic