Download Skin Infections in Community Pharmacy

Michelle Whyte
Pharmacist
Kawerau Pharmacy
Largest organ in the human body
Key role in immunity (interfaces with the
environment – protection from bacteria,
viruses, fungi)
Controls water loss
Insulation
Temperature regulation
Sensation
Synthesis of Vitamin D
Pain
Redness
Swelling
Heat
Loss of function
All skin wounds are colonised by bacteria but
not all are infected
Most minor skin infections are self limiting
Wounds will show symptoms of inflammation
while healing – care not to confuse with
infection
Need to watch for multiple wounds
New or increased pain
Swelling
Erythema (redness)
Purulent exudate
Malodour
Localised warmth
Multiple sites eg impetigo
Antiseptic – not always necessary
Saline wash – not always necessary
Appropriate dressings – waterproof, nonwaterproof and gentle paper dressings (for
delicate skin)
Preventing cross-contamination
Referral if necessary
Reduces infection risk
Increases healing rate
Reduces scarring
Change dressing every 2 to 3 days or more
frequently if a lot of bleeding occurs
Most dressings allow you to be able to see
the discharge coming from a wound so you
can monitor if it is infected or not
Diabetic
Chemotherapy patients
Elderly
History of cellulitis
Tracking from wound site up the vein
Multiple infected wound sites that require
oral antibiotics
Wound that needs cleaning (debris in wound)
Deep wounds that require stitches (deep,
high movement area of body)
Draw around the outside of the red ring
around the wound and write the time next to
the line
Every few hours repeat this process
If the redness covers a bigger area each time
then need to refer to the doctor
Watch for tracking
Prevent growth and development of a wide range
of micromicro-organisms without necessarily killing
them.
Work externally only
Help to prevent infections
Can contribute to bacterial resistance but not to
the same extent as antibiotics
Available on prescription and over the counter
Some controversy over whether they slow down
the healing process
Some are not suitable for use on open wounds
Contains povidone iodine
Cream is funded on prescription
Apply two to three times daily
Got for a wide variety of micro-organisms
(bacteria, viruses, fungi)
Cetrimide, chlorhexidine
Use once or twice a day
Chloroxylenol
Dilute according to pack and use to cleanse
wound
Contains hydrogen peroxide
No known resistance to crystaderm
Apply two to three times a day and do not
use for longer than 3 weeks
Chemicals that kill and stop the growth of
bacteria
Only work on bacteria
Issues with bacterial resistance
Should only be used for minor localised areas
of infection eg impetigo
Only available on prescription
It is important that it is used until the wound
has completely cleared up to prevent
resistance issues (do not use intermittently)
First line treatment
One tube per prescription is funded, repeats
are not funded
Recently was on the news in regards to
helping increase antibiotic resistant rates
Often prescribed with an oral antibiotic
Second line agent when treating Fobanresistant bacteria
Should be reserved for treatment of MRSA
that is not resistant to Bactroban (via testing)