Snapshot A 25-year-old woman presents to the urgent care clinic for vaginal itching and discharge. She recently completed a course of antibiotics for the treatment of urinary tract infection. On physical exam, there is white discharge with erythema and swelling of the vulva. She requests a topical agent, as she did not want to take any medications by mouth. She is instructed to use a topical cream. (Vaginal candidiasis) Introduction Drugs nystatin topical use only side effects are too toxic to be given systemically Mechanism of action binds to ergosterol, a key component of the cell membrane, which forms pores that allow for leakage of cellular contents Clinical use candidiasis cutaneous (intertrigo and diaper rash) mucocutaneous (oral thrush and vaginal candidiasis) Adverse effects skin irritation or hypersensitivity