Prescribing topical medicines for skin infection - An update

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This report provides an update on the use and monitoring of topical antibiotics between January, 2016 and March, 2018 in primary care in New Zealand.

What prescribers need to know

  • Fusidic acid should NOT be used as a first-line treatment for skin infections, wound management, infected eczema or impetigo
  • Good hygiene measures and topical antiseptics such as hydrogen peroxide or povidone iodine should be used for minor skin infections
  • If antibiotics are required for skin infections, oral antibiotics are preferred
  • Topical antibiotics should be prescribed for short courses only, e.g. five to seven days, to minimise the development of resistance

Log in if you are a prescriber, to see your personalised and practice prescribing data.


The graph below shows your trends in topical antibiotic prescribing over the past two years.* If you are following best practice guidance you should see a decrease in the use of fusidic acid and an increase in hydrogen peroxide and iodine.

* The large decrease in mupirocin dispensing in 2016 was due to low/no stock during this time

The graph below allows you to compare your trends in fusidic acid and mupirocin prescribing with your peers over the past two years. This is standardised to a rate of prescribing per 1000 patients. If your prescribing of fusidic acid is much higher than your peers, it may be a good idea to undertake an audit to investigate the indications your have prescribed this for.

Your comparator is the average prescribing rate of ten general practitioners whose patient populations (i.e.patients they have prescribed for) are similar to yours in: gender, age and ethnicity.

How was the rate calculated?

If, for example, there were 10 prescriptions that you wrote for fusidic acid dispensed in Q1, 2016, and there were a total of 1500 patients who were dispensed any prescription written by you in this time period, we would divide 10 by 1500 and then multiply by 1000 to get a rate of 6.7 dispensed prescriptions per 1000 patients, that you could then compare to other prescribers.

To download a printable version of your prescribing reports, go to the reports section of your my bpac

Also see the article related to this report: Topical antibiotics: keep reducing use

The graph below shows your trends in topical antibioic prescribing over the past two years.* If you are following best practice guidance you should see a decrease in the use of fusidic acid and an increase in hydrogen peroxide and iodine.

* The large decrease in mupirocin dispensing in 2016 was due to low/no stock during this time


The graph below allows you to compare your trends in fusidic acid and mupirocin prescribing with comparator practices over the past two years. This is standardised to a rate of prescribing per 1000 enrolled patients. If your prescribing of fusidic acid is much higher than your comparators, it may be a good idea to undertake an audit to investigate the indications you have prescribed this for.

Your comparator is the average prescribing rate of ten practices whose patient populations are similar to yours in: gender, age, deprivation and ethnicity.

How was the rate calculated?

If, for example, your practice had 10 prescriptions for fusidic acid dispensed in Q1, 2016, and there were a total of 1500 patients enrolled in your practice in this time period, we would divide 10 by 1500 and then multiply by 1000 to get a rate of 6.7 dispensed prescriptions per 1000 patients, that you could then compare to other practices.

To download a printable version of your prescribing reports, go to the reports section of your my bpac

Also see the article related to this report: Topical antibiotics: keep reducing use

The use of topical fusidic acid has reduced by almost 50% over the last year; however, with few indications for use rates of prescribing could be even lower. To read more about this issue see: www.bpac.org.nz/2018/topical-antibiotics.aspx

Published: 16 July 2018


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