Topical Preparation in Hospital Keningau

	TOPICAL PREPARATION	DOSING		PRESCRIBER CATEGORY		REMARK
BACTERIAL SKIN CONDITION
Impetigo (Superficial Skin Infection)	Fusidic Acid 2% Cream	q8-12h for 7 days		A		⚫ Do not use for more than 2 weeks. ⚫ May use again if infection relapse
	Mupirocin 2% Ointment	q8-12h for 5 days		A
Cellulitis	Potassium  Permanganate 5%	OD-TDS		C
PARASITIC SKIN INFECTION
Scabies   Also may refer to this link: https://askdis.blogspot.com/2019/07/scabies-2019.html	Emulsion Benzyl Benzoate (EBB) 25%	OD x 2-3/7 Wash off after 24 hours (with a bath taken in between each application)		C
	Permethrin 5%	Once , repeat 1 week later Wash off after 8-12 hours		A/KK		NOT available for JPL
	Crotamiton 10%	Once daily up to 7 days (for nodular scabies TDS for 7-14 days)		B
	Calamine with 6% Sulphur	OD x 3/7 Wash off after 24 hours (with a bath taken in between each application)		C
	Patient Category		Choices Available
	Newborn to 2 months of age		Calamine with 6% Sulphur		Crotamiton 10%
	Children (2 mo to 2 yrs)		Calamine with 6% Sulphur		Crotamiton 10%		Permethrin 5%
	Children (2-12yrs)		Emulsion Benzyl Benzoate (EBB) 12.5%		Crotamiton 10%		Permethrin 5%
	Adult		Emulsion Benzyl Benzoate (EBB) 25%		Crotamiton 10%		Permethrin 5%
	Pregnant Woman		Permethrin 5%		Calamine with 6% Sulphur
Head Lice	Permethrin 1% Shampoo	Once, then reapply after 7-10 days		B
	Benzene Hexachloride GBH 0.1%	Not available
FUNGAL SKIN INFECTION
Dermatophyte infections (Dermatophytoses)	Miconazole cream 2%	Apply twice daily to affected area optimally for 4 weeks including 2 weeks after lesions have cleared.		B		Apply 2-3 cm beyond advancing margin of lesion.
	Clotrimazole cream 1%			B
	Miconazole powder	Not available
Pityriasis Versicolor	Selenium Sulphide 2.5 % Shampoo	Apply daily for 1 week to affected areas for 10-15 minutes followed by a shower & rinse off. Then apply 2-3 times per week.		A/KK
	Ketoconazole shampoo	Not available
	Topical Imidazole -Miconazole cream -Clotrimazole cream	Apply twice daily to affected area optimally for 4 weeks including 2 weeks after lesions have cleared.		B		Apply 2-3 cm beyond advancing margin of lesion.
Cutaneous Candidiasis	Miconazole cream 2%	Apply twice daily to affected area optimally for 4 weeks including 2 weeks after lesions have cleared.		B		Apply 2-3 cm beyond advancing margin of lesion.
	Clotrimazole cream 1%
	Nystatin cream	Not available
	Whitfield Ointment	Twice daily in a thin layer to the affected parts of the skin.		C		Treatment              may                                       take several weeks

 

VIRAL SKIN INFECTIONS
Warts	Salicylic Acid 1-20 %	Once to twice daily	C	**Prepared by HKGU , available in 1%, 2%, 5%, 10%, 20%
	Podophyllum  10-20 %	Not available
	Imiquimod 5% cr eam	Not available
Eczema & Dermatitis	1) Emollient
	Aqueous Cream	As a soap ⚫ To apply cream/ ointment on cotton wool. Then wet the body, smear the cotton wool onto the skin. Wash and then use the dry cotton wool to remove excess oil. As an emollient ⚫ To apply after taking a bath or showering when the skin is moist. ⚫ To apply emollients liberally (at least 2-4 times a day).	C
	Liquid paraffin		C
	Glycerin + Aqueous Cream		C	**Prepared by HKGU , available as Glycerin 10% + Aqueous cream or Glycerin 20% + Aqueous cream
	White soft paraffin		C
	Cerbamide (Urea) 10% Cream	Not available
	Emulsifying ointment	Not available
	2) Topical corticosteroid
	Hydrocortisone 1% cream	Three times daily over face, ear or flexural or elderly with thin skin	B	Mild potency
	Betamethasone 1:10 cream (0.01%)		B
	Betamethasone 1:4 cream (0.025%)	Two- three times daily over any site	B	Moderate potency
	Betamethasone 1:2 Cream (0.05%)	Once daily over body and limbs	B	Potent
	Betamethasone 1:1 Cream (0.1%)		A
	3) Topical Calcineurin Inhibitors (TCIS)
	Tacrolimus 0.03 %  &  0.1%  ointment	Not available
	Silver nitrate 0.5% ,  2%, 5%, 10%	Not available
Psoriasis	1) Topical Corticosteroid  -  as mentioned above
	2) Tar based preparation
	Tar Ointment	Apply sparingly to affected areas 1-3 times daily starting with low strength preparation	B	**Prepared by HKGU , available in 1%, 2%, 3%, 6%, 8%   Usually apply at night due to unpleasant smell
	Coal Tar 20% Solution	1 cap (15 ml) added to 10L of water in a pail. Soak diluted solution for 20 minutes	B
	3) Vitamin D Analogue  -  Not available
	4) Dithranol (Anthralin) -  Not available
Acne Vulgaris	1) Cetrimide 1%	Apply solution onto the face twice daily	B	Mix with water on palms, rub hand together until froth, apply froth on face,  rinse off with water
	2) Benzyl peroxide	Not available
	3) Adapalene,  Tretinoin	Not available
	4) Azelaic acid 20% cream	Not available

 

Remark

·       Availability may change from time to time depending on supplier, contract change, etc.

·       Please do consult pharmacist for latest availability.

·       Menthol may be added into certain preparation (usually aqueous cream) upon request.

·       Item maybe be kept by Hospital Keningau if allowed by Dermatology HQE.

 

References:  (1) Topical Preparations Counselling Guide for Pharmacist, 2018 ; (2) Hospital Keningau Drug Formulary, August 2020 ; (3) UptoDate ; (4) Bluebook

 Reviewed on 25/8/2020 by Nabiha  ; Edited on 04/09/2020 by JCK Ho