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Igloo has given you great, really textbook info. I will also, as a nurse, agree with the fact that culture and testing is crucial here. What happens is that, especially in elders who have required antibiotic, treatment is given with little testing. That means that fungal infections are treated as bacterially, and vice versa. Often the two infections begin to "play around" with one another, a fungal infection taking the place of a bacterial, then going bacterial when a fungal medication is applied. Believe it or not, as a lifelong nurse, it was actually a veterinarian who taught me that often dogs get a rash on exposed belly from an allergy, then it gets treated with antibacterial and good bacteria are wiped out; then fungus takes over. Someone tests and finds a fungal problem and THAT is treated and it goes bacterial again. It can be a real merry-go-round. I wish you good luck. When I was in nursing, due to the enormous expense of the product, the one you are currently using was often used more for burn patients than for others. Times they are a-changin.
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Have her doc’s run a culture to find out exactly what it is?
& is the DX from a dermatologist & who saw her in person?
I ask as there’s different skin fungal & bacterial infections and there’s a few new prescription drugs that work quite well for specific diseases. Treating fungal is slightly different that treating bacterial.

My family has done lots of on the water stuff plus live in high humidity and have tried all sorts of specialty derm medications, here’s my take:
- silver / sulfa drugs, IMO there’s a lot of “silver” that’s OTC, as silver promotes skin healing. Silver infused band aids get used often for wound care. The sulfa is the part that would be used to deal with the infection. Silvadene is a silver / sulfa drug that’s used widely for burns. You see a tube often in commercial kitchens as it’s good for bad 2nd degree buns. Like dab it on & slap a waterproof heavy duty band over the burn and get back to working the line & it’s all good.
- Luzu / Lulicorazole 1% cream, is amazing for tinea. It’s been around maybe a decade, so there’s a generic ($100 or so). Regular Luzu is $200-$300.
- Ala-Quin / Hydrocortisone .5% & Iodochloroxyquin 3% cream. The steroid is for the redness and itching and the Iodo is a targeted type of antibiotic for fungal & bacterial infections. It worked amazing on stubborn fungal. It is not cheap, maybe $400-$600 per tube if it’s not in your insurance formulary. No generic. NDC 0316-0123-80

At these prices, you want to make sure just what type of infection it is. That’s the info a culture can provide.

Theres a whole segment of health that is wound care. If the rash has evolved into something more serious, you should ask for a wound care consultation. MediCARE and most other health insurance will cover wound care evaluation and some sort of basic training for the patient or a family member on how to properly do wound care.

Also there is another derm drug, Alo-Quin gel, that’s out there priced at 9K a tube if your drug plan formulary doesn’t include it. &Just crazy imo.
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I don’t even know what that is. Stick around for more responses. I wish you luck in curing this rash.
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