Patient Group Direction for the supply of Fusidic Acid 2% Cream by community
pharmacists in the management of Impetigo
Clinical condition
Clinical need which this PGD is intended
to address
Relevant national guidance
Criteria for inclusion for treatment
Criteria for exclusion for treatment
Action to be followed if patient excluded
Staff characteristics
Qualifications required
Additional requirements
Requirements for continuing training and
education
MAS/PGD03/OCT06/ISSUE004
Treatment of minor staphylococcal skin infections.
(Impetigo)
Joint Formulary 4th Edition, RCHT, PCTs & GPs
within Cornwall & Isles of Scilly. June 2003. Latest
edition of the BNF.
Patient must be registered with a Doctor in the area.
(see separate sheet) or a Temporary Resident
Minor skin infection limited to a few lesions in one
area of body. The rash consists of vesicles that weep
and then dry to form yellow-brown crusts.
Must obtain parental/guardian consent for treating a
child under the age of 16 years.
Patient must be present at consultation.
Multiple site skin infection.
Had impetigo within the last 3 months.
Allergy to any component of the cream.
Patient refuses treatment.
Presenting with any underlying skin condition on the
same area of the body as impetigo.
Concerns with regarding patient compliance with
topical medication.
Refer to GP for advice and treatment
Registered Community Pharmacist
Attendance at a specific training event organised by
Cornwall and Isles of Scilly PCT and the satisfactory
completion of post-event course work.
Regular update and review of treatments used to
treat common minor bacterial skin infections.
Patient Group Direction for the supply of Fusidic Acid 2% Cream by community
pharmacists in the management of Impetigo
Treatment
Name of medicine
Method of obtaining supply of medicine
Legal status of medicine
Dose of medicine
Method of administration
Total number of doses to be supplied
Follow up treatment which may be
required
Advice to be given to the patient before
or after treatment
Treatment records to be completed
Audit trail
MAS/PGD03/OCT06/ISSUE004
Fusidic Acid 2% Cream (Fucidin)
From Pharmacy stock
POM
Apply to lesions Three or Four times daily for 7 days.
Topical
1 x 15g tube.
If the skin infection spreads or there is no
improvement after 5 days, seek medical advice from
GP.
Wash hands before and after applying cream.
Where possible remove scabs by bathing in warm
water before applying the cream.
Impetigo is a very infectious condition. Important to
prevent infection spreading by using own flannels and
towels (hot wash after use).
Do not scratch or pick spots.
Suggest applying cream three times daily on school
days and four times daily at other times.
Inform school of condition.
Do not share cream with anyone else.
Name, address and DOB of patient. Date of supply.
Doctor’s name and Surgery. Signature of Pharmacist
making supply. Batch number and expiry date of
product. Completion of relevant checklist. Completion
of form and signature of patient/parent for
prescription charges/exemption.
Entry made on computerised patient records. Label
product with directions for use and “Supplied under
PGD”.
2 copies of the above information to be made.
1 copy to be retained in the pharmacy for 2 years.
1 copy to be sent to GP within 48 hours of supply for
inclusion in patient’s notes.
2 copies of the Audit Form to be made. Retain one
copy in the pharmacy and send one to the
Prescribing Team, Sedgemoor Centre for payment.
Paperwork to be forwarded to office once each
month.
Patient Group Direction for the supply of Fusidic Acid 2% Cream by community
pharmacists in the management of impetigo
Management
PGD developed by
Authorising Pharmacist
Cornwall and Isles of Scilly Primary Care
Trust, Prescribing Team
Rosalind Palmer
Prescribing Adviser
Cornwall and Isles of Scilly PCT
Signature of Authorising Pharmacist
Date of PGD
Date this PGD becomes due for review
August 2008
Approved by:
Name
Cornwall & Isles of Scilly PCT
Nominated Doctor
Cornwall & Isles of Scilly PCT
Pharmaceutical Adviser
MAS/PGD03/OCT06/ISSUE004
Signature
Customer Details
Name
Address
Check List for Management of Impetigo.
Yes
No
Yes
No
Patient is present at consultation
Parental consent obtained for child under 16years
Skin infection limited to a few lesions in one area only.
Site of skin infection seen.
Criteria for exclusion for treatment checked and none apply.
(see table below)
Consent form completed by Pharmacist & signed.
Prescription charge collected if applicable and form signed by
patient.
PMR completed and Fucidin Cream labelled as per PGD
Treatment regimen explained and understood
Advice given should condition not improve.
Follow up advice given
Hygiene
Prevention of condition spreading
Parent to inform school.
Pharmacist’s Signature
Date.
Criteria for exclusion for treatment
Already had an episode of impetigo within last 3 months
Allergy to Fucidin cream
Presenting with any underlying skin condition
If the patient answers yes to any of the above criteria they must be referred to GP.
MAS/PGD03/OCT06/ISSUE004