No está claro cuán grande es el papel de los antibióticos https://antibioticos-wiki.es en las relaciones competitivas entre los microorganismos en condiciones naturales. Zelman Waxman creía que este papel era mínimo, los antibióticos no se forman sino en culturas limpias en entornos ricos. Posteriormente, sin embargo, se descubrió que en muchos productos, la actividad de síntesis de antibióticos aumenta en presencia de otros tipos o productos específicos de su metabolismo.

Prescribing formulary - 12

file:///C|/Documents%20and%20Settings/james.lacey/Desktop/MAGGIE/ID%20816%20enc%2012.htm Chapter 13: Skin
The GHT Formulary applies to the treatment of adults only
13.1 Management of skin conditions
● Please refer to the BNF for information regarding vehicles, excipients, sensitisation and suitable quantities for prescribing.
13.2 Emollient and barrier preparations
How to locate a
drug in Hospital

13.2.1 Emollients
Emollient soap substitutes
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Emollients containing antimicrobials
13.2.1.1 Emollient bath additives
Emollient bath additives with antimicrobials
13.2.2 Barrier Preparations
Cavilon® no-sting barrier film applicators 1mL & 3mL - supplied by stores not pharmacy file:///C|/Documents%20and%20Settings/james.lacey/Desktop/MAGGIE/ID%20816%20enc%2012.htm (2 of 13)30/03/2011 16:04:14 file:///C|/Documents%20and%20Settings/james.lacey/Desktop/MAGGIE/ID%20816%20enc%2012.htm Siopel ® cream - Not to be used on broken skin
Zinc and castor oil ointment – zinc preparations are restricted to use by the dermatologists as Cavilon® and Siopel ® are the products in the Trust’s Wound Care Guidelines.
13.3 Topical local anaesthetics and antipruritics
Menthol in Aqueous cream 0.5% & 1% - are only available as ‘special’ preparations (i.e. not proprietary products). These preparations are not cost-effective in primary care and there may be a significant delay in obtaining such preparations.
Doxepin Hydrochloride 5% cream (Xepin®) – for small areas only. Restricted to dermatology. Doxepin cream can cause drowsiness that may affect skilled tasks and there may be a risk of sensitisation.
13.4 Topical corticosteroids
Suitable quantities of corticosteroid preparations to be prescribed for specific areas of the body Amount per application
Amount of
one leg grams per
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Clobetasone butyrate 0.05% (Eumovate®) cream/ointment Betamethasone valerate 0.025% (Betnovate RD®) cream/ointment Fludroxycortide 4 micrograms/cm2 (Haelan®) tape Fluocinolone 0.00625% (Synalar 1 in 4 Dilution®) cream/ointment Beclometasone dipropionate 0.025% (Propaderm®) cream/ointment Betamethasone valerate 0.1% (Betnovate®)cream/ointment/lotion Betamethasone dipropionate 0.05% with salicylic acid 3% (Diprosalic®) ointment Diflucortolone 0.1% (Nerisone®) oily cream Fluocinolone 0.025% (Synalar®) cream/ointment Mometasone furoate 0.1% (Elocon®) cream/ointment Very Potent
Clobetasol propionate 0.05% (Dermovate®) cream/ointment Diflucortolone 0.3% (Nerisone Forte®) oily cream Topical Steroids with antimicrobials
Hydrocortisone 1% and clioquinol 3% (Vioform–Hydrocortisone®) cream/ointment Hydrocortisone 1% and clotrimazole 1% (Canesten HC®) Hydrocortisone 1% and fusidic acid 2% (Fucidin H®) cream/ointment Hydrocortisone 1% and miconazole 2% (Daktacort®) cream/ointment Hydrocortisone 0.5% (cream), 1% (ointment), nystatin 100,000 units/g and chlorhexidine 1% (Nystaform HC®) Hydrocortisone 0.5%, nystatin 100,000 units/g, benzalkonium chloride solution 0.2% and dimeticone ‘350’ 10% (Timodine®) cream Moderate
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Clobetasol propionate 0.05%, neomycin sulphate 0.5% and nystatin 100,000 units/g (Dermovate NN®) cream/ointment Compound preparations
Hydrocortisone 0.25% and crotamiton 10% (Eurax-Hydrocortisone®) cream Moderate
Hydrocortisone 1% and urea 10% (Alphaderm®) cream Hydrocortisone 1%, urea 10%, lactic acid 5% (Calmurid HC®) cream Steroid scalp applications
Betamethasone 0.1% (Betacap®) scalp application, (Betnovate®) scalp application, (Bettamousse®) foam scalp application Betamethasone 0.05% and salicyclic acid 2% (Diprosalic®) scalp application Fluocinolone acetonide 0.025% (Synalar®) gel file:///C|/Documents%20and%20Settings/james.lacey/Desktop/MAGGIE/ID%20816%20enc%2012.htm (5 of 13)30/03/2011 16:04:14 file:///C|/Documents%20and%20Settings/james.lacey/Desktop/MAGGIE/ID%20816%20enc%2012.htm Very Potent
13.5 Preparations for Eczema and Psoriasis
13.5.1 Preparations for eczema
● Please refer to section 13.2 (emollients) and 13.4 (topical corticosteroids).
Zinc paste and ichthammol bandage – only to be applied by a Nurse skilled in ● Ichthammol cream (Hospital Formula 2%) is only available as a ‘special’ preparation (i.
e. not a proprietary product). These preparations are not cost-effective in primary care and there may be a significant delay in obtaining such preparations.
13.5.2 Preparations for psoriasis
Topical preparations
● Please refer to the BNF for information regarding vitamin D and analogues. Vitamin D and analogues
Calcipotriol with betamethasone 0.05% (Dovobet®) ointment Calcipotriol with betamethasone 0.05% (Dovobet®) gel – body and scalp Calcitriol 3micrograms/g (Silkis®) ointment ● Treatment with Dovobet® should be initiated by a specialist and not exceed 4 weeks. There is no experience of repeated use. Refer to BNF for dose information.
Topical retinoid
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● Chelsea Day mix (Hospital Formula) is only available as a ‘special’ preparation (i.e. not a proprietary product). These preparations are not cost-effective in primary care and there may be a significant delay in obtaining such preparations.
Alphosyl HC® Cream (with hydrocortisone 0.5%) Polytar® bath emollient (contains peanut oil) ● Chelsea Night mix and Coal Tar and Salicylic Acid ointments are only available as ‘special’ preparations (i.e. not proprietary products). These preparations are not cost-effective in primary care and there may be a significant delay in obtaining such preparations.
Dithranol
Dithrocream® 0.1%, 0.25%, 0.5%, 1% and 2% Dithranol in Lassar’s Paste 0.1%, 0.25%, 0.5%, 1%, ● Dithranols in Lassar’s Paste are only available as ‘special’ preparations (i.e. not proprietary products). These preparations are not cost-effective in primary care and there may be a significant delay in obtaining such preparations.
Oral retinoids for psoriasis
13.5.3 Drugs affecting the immune response
Tacrolimus 0.03% and 0.1% (Protopic®) ointment - specialist use only file:///C|/Documents%20and%20Settings/james.lacey/Desktop/MAGGIE/ID%20816%20enc%2012.htm (7 of 13)30/03/2011 16:04:14 file:///C|/Documents%20and%20Settings/james.lacey/Desktop/MAGGIE/ID%20816%20enc%2012.htm Pimecrolimus 1% cream - specialist use only Systemic
● Please refer to section 8.2.1 for systemic preparations 13.6 Acne and rosacea
13.6.1 Topical preparations for acne
Benzoyl peroxide and azelaic acid
Benzoyl peroxide aqueous gel (PanOxyl Aquagel®) 2.5%, 5%, 10% Benzoyl peroxide aqueous/alcoholic gel (Panoxyl® ) 5%, 10% Benzoyl peroxide 5% and clindamycin 1% (Duac® Once Daily) Topical antibacterials for acne
Clindamycin (aqueous)(Dalacin T® lotion) Clindamycin (aqueous/alcoholic) (Dalacin T® solution) Erythromycin 40mg/mL and zinc acetate 12mg/mL (Zineryt®) topical solution Topical retinoids and related preparations for acne
● Topical retinoids are contra-indicated in pregnancy. Women of childbearing age should take adequate contraceptive precautions.
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Oral antibacterials for acne
Hormone treatment for acne
Oral retinoid for acne
Isotretinoin capsules – Hospital consultant only 13.7 Preparations for warts and calluses
Salicylic acid 16.7% and lactic acid 16.7% (Salactol®) paint Salicylic acid 12% and lactic acid 4% (Salatac®) gel Salicylic acid 25% and podophyllum 20% (Posalfilin®) ointment Cantharone Plus® (Cantharidin, podophyllum resin, salicylic acid) – unlicensed Anogenital warts
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13.8 Sunscreens and camouflagers
13.8.1 Sunscreen preparations
● The following sunscreens may be prescribed for skin protection against ultraviolet radiation in abnormal cutaneous photosensitivity resulting from genetic disorders or photodermatoses, including vitiligo and those resulting from radiotherapy; chronic or recurrent herpes simplex labialis; patients taking photosensitising drugs and patients having PUVA.
Photodamage
13.9 Shampoos and other preparations for scalp and hair
conditions

● Please refer to the BNF for information regarding constituents. Polytar AF® shampoo (contains peanut oil) Polytar Plus® liquid (contains peanut oil) file:///C|/Documents%20and%20Settings/james.lacey/Desktop/MAGGIE/ID%20816%20enc%2012.htm (10 of 13)30/03/2011 16:04:14 file:///C|/Documents%20and%20Settings/james.lacey/Desktop/MAGGIE/ID%20816%20enc%2012.htm Salicylic acid and sulphur Hospital Formula scalp cream ● Salicylic acid and sulphur Hospital Formula scalp cream is only available as a ‘special’ preparation (i.e. not a proprietary product). These preparations are not cost-effective in primary care and there may be a significant delay in obtaining such preparations.
13.10 Anti-infective skin preparations
13.10.1 Antibacterial preparations
13.10.1.1 Antibacterial preparations only used topically
Polyfax® - polymixin B sulphate and bacitracin zinc ointment Flamazine® - silver sulfadiazine 1% cream Flammacerium ® cream (named patients) – burns patients only ● For mupirocin nasal ointment see section 12.2.3 13.10.1.2 Antibacterial preparations also used systemically
Metronidazole 0.75% cream/gel – For malodorous tumours and skin ulcers 13.10.2 Antifungal preparations
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Aciclovir 5% cream - should only be started at first sign of attack.
13.10.4 Parasiticidal preparations
● Alcoholic lotions are the treatment of choice for head lice but use aqueous solutions for patients with severe eczema or asthma.
Malathion 0.5% aqueous liquid (Derbac M®), 0.5% alcoholic lotion Carbaryl 1% aqueous liquid, 0.5% alcoholic lotion (Carylderm®) Phenothrin 0.5% aqueous liquid (Full Marks®) 13.10.5 Preparations for minor cuts and abrasions
Skin tissue adhesive
13.11 Skin cleansers and antiseptics
● Please refer to GHNHSFT Infection Control policy Astringents, oxidisers and dyes
Potassium permanganate (Permitabs® 400mg) 13.12 Antiperspirants
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● Please refer to the GHNHSFT Wound Management Formulary Topical treatments for scar reduction
Topical treatments for malignant and pre-malignant lesions
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Source: http://www.gloshospitals.nhs.uk/SharePoint2/Freedom%20of%20Information/disclosures/2011/February/ID%20816%20enc%2012.pdf

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