Treatment of Candidal Balanoposthitis When Antifungal Resistance Is Suspected or There Is an Allergy to Imidazoles

Imidazole antifungals are the conventional first choice for candidal balanoposthitis, but they are not always appropriate. When resistance to standard antifungal treatment is clinically suspected, or when the patient has a documented allergy to imidazoles, an alternative topical agent is needed.

This protocol targets candidal balanoposthitis in the setting of suspected antifungal resistance or allergy to imidazoles — circumstances in which imidazole-based topical therapy is either contraindicated or expected to be ineffective.

The protocol calls for a topical application of nystatin cream — an alternative to imidazole preparations suited to this specific scenario. The full regimen, including strength, frequency, and duration, is set out in the structured protocol below.