LAS VEGAS – Nondermatologists were 11 times more likely than dermatologists to prescribe nystatin for dermatophyte infections, according to a study that analyzed 12 years of ambulatory-care data in the United States.
The findings were presented in a poster at the Skin Disease Education Foundation’s annual Las Vegas Dermatology Seminar.
“Although it is effective for the treatment of cutaneous or mucocutaneous candidiasis, the topical polyene nystatin, however, is clinically ineffective in the treatment of dermatophyte infection,” wrote Jeave Reserva, MD, of the division of dermatology at Loyola University Health System in Illinois, and colleagues.
In their analysis, the researchers used 12 years of data from two separate surveys – the National Ambulatory Medical Care Surveys and the National Hospital Ambulatory Medical Care Survey–Emergency Department – collected between 2003 and 2014, as well as 9 years of data from the National Hospital Ambulatory Medical Care Survey–Outpatient Department collected between 2003 and 2011. They reviewed data from 48.4 million ambulatory-care visits for dermatophyte infections, including 1,459,184 visits in which nystatin was prescribed. Overall, nondermatologists were significantly more likely than dermatologists to prescribe nystatin. The researchers also found that, after controlling for race, gender, and insurance status, male or black patients were significantly more likely to have positive tinea infections.
Nondermatologists were 11.08 times more likely to prescribe nystatin for dermatophytosis, compared with dermatologists (P = .02), the researchers found.
Although the number of visits does not reflect disease prevalence, the results suggest that health care disparities affect patients presenting with dermatophytosis, the researchers said. “Nondermatologists may benefit from additional provider education on the diagnosis and appropriate treatment of dermatophyte infections,” they concluded.
The researchers had no financial conflicts to disclose; no funding source was listed.
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