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If the condition doesn’t improve within two weeks of home treatments, then you either require a prescription-strength antifungal option, or it may be possible that your jock itch is bacterial instead of fungal. Your doctor will also be able to prescribe antibiotics if this is the case. Your doctor will likely swab the affected area and send the swab to a lab for a culture. This skin culture will help your doctor determine whether the jock itch is indeed fungal or caused by bacteria (commonly staphylococcus). If your doctor determines that the condition is fungal, but over-the-counter treatments didn’t work for two (or more) weeks, then your doctor will likely recommend a prescription-strength antifungal cream. These options include:  Oxiconazole 1% (Oxistat) Econazole 1% (Spectazole) Sulconazole 1% (Exelderm) Ciclopirox 0.77% (Loprox) Naftifine 2% cream Note that econazole, sulconazole, ciclopirox, and naftifine cannot be used in children. The side effect of these drugs include burning sensation, skin irritation, stinging, and redness. If your case of jock itch has been recurrent or if you are immunosuppressed (such as those with HIV), then your doctor may suggest stronger, oral antifungal drugs. These options may include:  Griseofulvin 250 mg twice daily until cure is reached Terbinafine 250 mg/day for 2-4 weeks Itraconazole 200 mg/day for 1 week Fluconazole 150 - 300 mg/week for 2-4 weeks Ketoconazole 200 mg/day for 4-8 weeks Note that these medications cannot be used in children or in pregnant women. The common side effects of these drugs include liver damage, dizziness, seizures, nausea, and vomiting. When prescribed, physicians generally monitor the patient's liver functioning periodically. If the culture confirms that your condition is actually the result of a bacterial skin infection, then your doctor will discuss antibacterial creams to apply to the area. These options may include:  Erythromycin applied twice daily Clindamycin applied twice daily Metronidazole applied twice daily Your doctor may also recommend that you use an antibacterial soap to wash the skin before applying these. OTC antibacterial soaps include Lever 2000 or a chlorhexidine soap such as Hibiclens. For more-severe cases of bacterial jock itch, your doctor will prescribe a course of oral antibiotics. Depending on the drug, the prescription could be for anywhere between 5 and 14 days. Some of these antibiotics include:  Cephalexin (Keflex) Dicloxacillin Doxycycline Minocycline (Dynacin or Minocin) Erythromycin
See your doctor if the condition doesn’t improve in two weeks. Discuss prescription antifungal creams. Ask about oral antifungal medications. Discuss topical antibiotic options. Inquire about oral antibiotic options.