In 2021, approximately 6.5 million topical antifungal prescriptions were filled by Medicare Part D beneficiaries in the United States, with an average of 134 prescriptions per 1,000 beneficiaries. The total cost was $231 million. Primary care physicians wrote the highest percentage of prescriptions (40.0%), followed by nurse practitioners or physician assistants (21.4%), dermatologists (17.6%), and podiatrists (14.1%). Higher-volume prescribers, defined as the top 10% of prescribers by volume, wrote 44.2% of all prescriptions. These findings highlight the importance of understanding current prescribing practices and encouraging judicious use of topical antifungals to combat the emergence of antimicrobial-resistant superficial fungal infections. The study also found that 10% of antifungal prescribers wrote nearly half of all prescriptions, indicating a need for targeted interventions. The use of combination antifungal-corticosteroid medications, such as clotrimazole-betamethasone dipropionate, is particularly concerning due to its potential role in promoting antimicrobial resistance. Clinicians should be aware of the risks associated with these medications and consider alternatives. The study also noted that the actual volume of topical antifungal use may be higher than reported due to the availability of over-the-counter medications not captured in CMS data. The findings emphasize the need for improved patient education and better understanding of prescribing practices to ensure appropriate use of these medications.In 2021, approximately 6.5 million topical antifungal prescriptions were filled by Medicare Part D beneficiaries in the United States, with an average of 134 prescriptions per 1,000 beneficiaries. The total cost was $231 million. Primary care physicians wrote the highest percentage of prescriptions (40.0%), followed by nurse practitioners or physician assistants (21.4%), dermatologists (17.6%), and podiatrists (14.1%). Higher-volume prescribers, defined as the top 10% of prescribers by volume, wrote 44.2% of all prescriptions. These findings highlight the importance of understanding current prescribing practices and encouraging judicious use of topical antifungals to combat the emergence of antimicrobial-resistant superficial fungal infections. The study also found that 10% of antifungal prescribers wrote nearly half of all prescriptions, indicating a need for targeted interventions. The use of combination antifungal-corticosteroid medications, such as clotrimazole-betamethasone dipropionate, is particularly concerning due to its potential role in promoting antimicrobial resistance. Clinicians should be aware of the risks associated with these medications and consider alternatives. The study also noted that the actual volume of topical antifungal use may be higher than reported due to the availability of over-the-counter medications not captured in CMS data. The findings emphasize the need for improved patient education and better understanding of prescribing practices to ensure appropriate use of these medications.