Rosh Pediatrics Practice Exam

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For a 10-month-old infant with a rash consistent with diaper candidiasis, what is the recommended treatment?

Hydrocortisone
Nystatin
Zinc oxide based barrier paste
Zinc oxide based barrier paste and nystatin

The correct answer is: Zinc oxide based barrier paste and nystatin

For a 10-month-old infant with a rash consistent with diaper candidiasis, the recommended treatment involves both a zinc oxide-based barrier paste and nystatin. This combination addresses the infection effectively while also protecting the skin. Nystatin is an antifungal medication specifically effective against Candida species, which are responsible for diaper candidiasis. It works by binding to the fungal cell membrane, leading to leakage of cellular contents and ultimately inhibiting the growth of the fungus. Adding a zinc oxide-based barrier paste to the treatment plan serves a dual purpose. Firstly, it provides a protective barrier against moisture and irritants, which can exacerbate the condition and hinder the healing process. Secondly, zinc oxide has mild antiseptic and astringent properties that can aid in soothing irritated skin. Using this combination of treatment not only targets the underlying fungal infection with nystatin but also helps to prevent further skin irritation by maintaining a protective barrier, making it the most comprehensive approach for managing diaper candidiasis in infants.