Supply of Fusidic Acid Cream 2% by Community Pharmacists for the treatment of impetigo in patients 2 years of age and over. November 2017 Review Nov 2019 Signatures of those developing the Patient Group Direction Job Title Name Signature Date Doctor Stephanie Dundas Signed by Stephanie 6/12/17 Chair NHS Lanarkshire Antimicrobial Dundas Management Team, Pharmacist Steve McCormick Area Antimicrobial Pharmacist Signed by Steve McCormick 7/12/17 Approval from Primary Care Drugs and Therapeutics Committee Chair Signed on behalf of group Date Primary Care Drugs and George Signed by George Lindsay 6/12/17 Therapeutics Committee Lindsay Approval for use in NHS Lanarkshire Job Title Name Signature Date Medical Director Iain Wallace Signed by Iain Wallace 6/12/17 Director of Pharmacy Christine Gilmour Signed by Christine Gilmour 6/12/17 Original Signature on file This document authorises the supply of fusidic acid cream 2% by appropriate practitioners to patients who meet the criteria for inclusion under the terms of the document. Practitioners seeking to supply fusidic acid cream 2% must ensure that they assess all clients to make sure they meet the criteria before supplying the product. The purpose of this Patient Group Direction is to help patients by ensuring that they have ready access to a quality assured service which provides a timely, consistent and appropriate supply of fusidic acid cream 2% for the treatment of impetigo for patients aged 2 years of age and over.
CLINICAL CONDITION Indication Inclusion Criteria Exclusion Criteria Caution/ Need for further advice Action if Patient declines or is excluded Treatment of minor staphylococcal skin infections. (Impetigo) Adults and children aged 2 years or older with 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. 1. Multiple site skin infection. 2. Children under the age of 2 years. 3. Had impetigo within the last 3 months. 4. Allergy to any component of the cream. 5. Patient refuses treatment. 6. Presenting with any underlying skin condition on the same area of the body as impetigo. 7. Concerns with regarding patient compliance with topical medication. 8. Systemically unwell Refer patient to GP / OOH for review
DRUG DETAILS Name, form & strength of medicine Legal Status Route/ Method Dosage Frequency Duration of treatment Maximum or minimum treatment period Quantity to Supply/ administer Side Effects Fusidic Acid 2% Cream POM Topical Apply to lesions Four times daily for 7 days. Maximum treatment 7 days. Use for a maximum of 7 days. Maximum of one supply in three months. 1 x 15g tube Side effects with this product are rare however hypersensitivity reactions may occur For a full list of side effects refer to the marketing authorisation holder s Summary of Product Characteristics (SPC). A copy of the SPC must be available to the health professional administering medication under this Patient Group Direction. This can be accessed on www.medicines.org.uk Advice to patient/carer All adverse reactions that are serious or result in harm should be reported to the MHRA through the Yellow Card Scheme 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. Inform of possible side effects and their management. Follow up The Drug Manufacturer Patient Information Leaflet should be given. Patients should be informed who to contact should they experience an adverse drug reaction If the skin infection spreads or there is no improvement after 5 days, seek medical advice from GP.
STAFF CHARACTERISTICS Qualifications Specialist competencies or Qualifications Continuing Training & Education Pharmacist currently registered with the General Pharmaceutical Council It is a mandatory training requirement to complete the NHS Education Scotland Pharmacy First e-training module and obtain a pass certificate. The can be found on the NES TURAS website https://learn.nes.nhs.scot/ If you sign into the website, then under find resources search for Pharmacy First and the online module should be the first result and you select the launch icon to start Up to date knowledge in therapeutic area. Will participate in ongoing evaluation of this initiative which will include sharing of anonymised case studies and cooperating with Pharmacy First champions.
REFERRAL ARRANGEMENTS & AUDIT TRAIL Referral arrangements Ensure patient is aware that if symptoms worsen or the skin infection spreads then they should seek medical advice either from their GP or through OOH centre. If symptoms have not improved after five days treatment, then patients should be advised to seek further medical advice. Records/audit trail. A record of supply should be made on PMR which includes Name, strength, form and pack size of medicine supplies, dose and route of administration, date of supply and name of person making supply The medicine must be labelled in accordance with requirements detailed in the current version of Medicines, Ethics and Practice. The patient s GP must be notified that a supply has taken place. In addition the OOH service must be notified if the supply is made in the out of hours period i.e. outwith the hours when the patients GP surgery is open The patient s GP must be informed if the patient experiences an adverse drug reaction A computer or manual record of all individuals receiving a supply under this PGD should also be kept for audit purposes. Any adverse incidents should be reported to the NHS Lanarkshire Primary Care Chief Pharmacist in addition to any existing pharmacy processes Reference sources and comments Records of supply should be kept for 8 years Electronic Medicines Compendium (www.medicines.org.uk)
Supply of Fusidic Acid Cream 2% by Community Pharmacists for the treatment of impetigo in patients 2 years of age and over. Individual Authorisation November 2017 Review Nov 2019 This PGD does not remove inherent professional obligations or accountability It is the responsibility of each professional to practice only within the bounds of their own competence and in accordance with their own Code of Professional Conduct. It is also your responsibility to ensure that all consultations with patients occur within a private and confidential area of the pharmacy. I have read and fully understand the Patient Group Direction for the supply of Fusidic Acid Cream 2% and agree to provide this medicine only in accordance with this PGD in NHS Lanarkshire Community Pharmacies. Name of Pharmacist GPhC Number Pharmacy Address Contractor Code Signature Date The above person has been authorised to use this protocol Signature of Authorising Pharmacist on behalf of Employing Organisation Name Signature Date Note : A copy of this agreement must be signed for each pharmacist who wishes to be authorised to use the PGD for Supply of Fusidic Acid Cream 2% by Community Pharmacists working in N H S L a n a r k s h i r e Community Pharmacies. Please return this form a l o n g w i t h a c o p y o f y o u r N E S P h a r m a c y F i r s t e - l e a r n i n g P a s s C e r t i f i c a t e to Pharmacy A d m i n Services, NHS Lanarkshire Fallside Road Bothwell G71 8BB e-mail Pharmacy.AdminTeam@lanarkshire.scot.nhs.uk Fax: 01698 858271 A copy of the agreement, NHS Pharmacy First Pass certificate and PGD must also be kept readily available in the pharmacy for reference.