Nystatin is commonly prescribed as prophylaxis in children beyond the neonatal age

Lay Summary The topical antifungal nystatin has not many indications. Prophylaxis of invasive candidiasis in very low birth weight neonates is one of them. In our study, we found that nystatin prophylaxis was used frequently beyond this specific neonatal group. Stronger evidence justifying its use is required. The indications for nystatin as prophylaxis or treatment are limited. In the PASOAP (Pediatric Antifungal Stewardship Optimizing Antifungal Prescription) study, high use of nystatin in hospitalized children beyond the neonatal age was observed. In this report, we present the data on nystatin use in infants and children >= 3 months who participated in the PASOAP study. Nystatin was prescribed mainly for prophylaxis. Congenital heart disease, cystic fibrosis, and chronic renal disease were the most commonly reported conditions in children receiving prophylactic nystatin. There is sparse evidence supporting the use of nystatin prophylaxis beyond neonates; trials in specific pediatric patient groups are required.

Automated summary

The topical antifungal nystatin has limited indications, but its use is observed beyond very low birth weight neonates. This study found high use of nystatin in hospitalized children beyond the neonatal age. Nystatin was mainly prescribed for prophylaxis, with congenital heart disease, cystic fibrosis, and chronic renal disease being the most common conditions in children receiving prophylactic nystatin. Sparse evidence supports the use of nystatin prophylaxis beyond neonates, indicating the need for trials in specific pediatric patient groups.