chlorhexidine hydrochloride + nystatin: clinical use

Prescribing considerations

• Confirm that the presentation is consistent with fungal and/or bacterial skin infection.
• Review if the condition worsens, fails to improve or a new infection appears; consider an alternative diagnosis or treatment.
• Avoid ocular and oral exposure and counsel about chlorhexidine hypersensitivity.

Contraindications and cautions

• Hypersensitivity to nystatin, chlorhexidine hydrochloride or any excipient.
• Possible previous allergic reaction to any chlorhexidine-containing product or device.

Monitoring

• Clinical response and evidence of a new or worsening infection.
• Local sensitivity, contact dermatitis or systemic hypersensitivity.

Clinical pharmacology

Nystatin is fungistatic and fungicidal against susceptible fungi, particularly Candida albicans; chlorhexidine has broad antibacterial activity. Topical nystatin has negligible absorption through skin or mucous membranes.

Formulation and product differences

• The selected product is a water-miscible, light-yellow topical cream without a corticosteroid.
• Cetostearyl alcohol may cause local skin reactions; benzyl alcohol may cause allergic reactions or mild local irritation.
• Products carrying “HC” in the name also contain hydrocortisone and are not equivalent to this two-ingredient cream.