Back
to topBack to Section 13 Selection Page
13.10
Anti-infective
skin preparations
Antibacterial
Preparations
Antibacterials
not used systemically
Silver
sulfadiazine
cream 1%
Dose:
Apply with sterile applicator; burns, apply daily or more frequently if very
exudative; leg ulcers or pressure sores apply daily or on alternate days (not
recommended if ulcer is very exudative); finger tip injuries, apply every 2-3
days.
Antibacterials
also used systemically
Fusidic
acid
cream, ointment, gel 2%
Dose:
Apply 3 to 4 times daily for up to 7 days.
Metronidazole
cream,
gel 0.75%
Dose: Acute inflammatory exacerbation of acne
rosacea, apply thinly twice-daily for 8-9 weeks; avoid contact with eyes.
Antifungal
preparations
FIRST CHOICE: CLOTRIMAZOLE cream
Clotrimazole
cream
1%
Dose: Apply 2-3 times daily, continuing for
14 days after lesions have healed.
Ketoconazole
cream
2%
Dose:
Apply
1-2 times daily
NB Only prescribable for seborrhoeic dermatitis and pityriasis versicolor. Endorse SLS.
Miconazole
cream 2%
Dose: Apply twice-daily continuing for 10
days after lesions have healed.
Terbinafine
cream 1%
Dose: Apply thinly 1-2 times daily for up to
1 week in tinea pedis, 1 to 2 weeks in tinea corporis and tinea cruris, 2 weeks
in cutaneous candidiasis and pityriasis versicolor; review after 2 weeks.
Not recommended for children.
Antiviral
preparations
Aciclovir
cream 5%
Dose: Apply to herpes simplex lesions every 4
hours (5 times daily) for 5 days, started at first sign of attack.
Treatment of lice and scabies
Dimeticone
4%
lotion
Dose:
Head lice, rub into dry hair and scalp, allow to dry naturally, shampoo
after a minimum of 8 hours (or overnight); repeat application after 7 days.
Malathion
0.5%
in aqueous basis
Dose:
Head lice, rub into dry hair and scalp, allow to dry naturally, remove by
washing after 12 hours and repeat treatment after 7 days.
Crab/pubic lice, apply aqueous preparation to all
parts of the body (not merely the groin and axillae) for 12 hours, or overnight;
a second treatment needed after 7 days to kill lice emerging from surviving
eggs.
Several products are available which require the use of a fine tooth plastic detection comb and hair conditioner; a head lice device (Bug Buster® Kit) is prescribable on the NHS. The methods typically involve meticulous combing with the detection comb over the whole scalp at 4 day intervals for at least 2 weeks.
Permethrin
cream 5%
Dose:
Scabies: apply over whole body including face, neck and ears and wash off
after 8 to 12 hours. Those with sparse hair should also apply the cream to their
scalp. If hands are washed with
soap and water within 8 hours of application, cream should be re-applied.
Repeat treatment after 7 days. All
members of household/close contacts should be treated once only.
Refer
to notes on “treatment of scabies” click here
For further information on scabies see the Scabies Dermatology Referral and Management Pathway.
© 2010 NHS Tayside