Athlete’s Foot

Please refer to the BNF or SPC for licenced indications, doses, contraindications and other prescribing information.

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Definition/Criteria

Athlete’s foot is a skin disease caused by a fungus, usually occurring between the toes.

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Criteria for INCLUSION

Treat Patients who present with characteristic symptoms of athlete’s foot.

------Criteria for EXCLUSION

  • Patients aged <12 years of age
  • Pregnant and breast feeding women
  • Diabetic patients
  • Fungal infection started to spread into the nails or to other areas of the body, e.g. nail thickened, discoloured or deformed
  • Other concurrent local symptoms

------Action for excluded patients and non-complying patients

Refer to GP*

------Action for patients who are included for treatment

Advice

  • Explain that fungal spores survive in warm damp areas and can be picked up from swimming pools, baths, shared towels or wet floors
  • Advise to ensure good hygiene
  • Wear footwear that keeps the feet cool and dry and change to a different pair of shoes every 2 to 3 days
  • Wearing cotton socks will help
  • After washing dry the feet thoroughly, especially between toes
  • Do not share towels and wash them frequently

To reduce the risk of transmission

  • Avoid scratching affected skin as this may spread the infection to other sites
  • Avoid going barefoot in public places, for example use protective footwear such as flip flops in communal changing areas

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Treatment choice from the formulary

Terbinafine hydrochloride 1% cream 15g ( patients > 16 years only)

Apply to the affected area 1 to 2 times daily for up to one week

  • Relief of clinical symptoms usually occurs within a few days. If there are no signs of improvement after one week the patient should visit the GP for a confirmation of diagnosis
  • Advise patient that for the treatment to be effective it is important to use the cream regularly and complete the course

Supply one treatment course in 6 months. Two treatment courses in 12 months, Patients seeking treatment more frequently should be referred to the GP

Clotrimazole 1% cream 20g

Apply to the affected area 2 to 3 times daily.

  • If there are no signs of improvement after one week the patient should visit the GP for confirmation of diagnosis
  • Advise patient that for the treatment to be effective it is important to use the cream regularly and complete the course

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Routine referral to GP*

  • Patients aged < 12 years of age
  • Pregnant and breast feeding women
  • Diabetic patients
  • Fungal infection started to spread into the nails to other areas of the body, e.g. nail thickened, discoloured or deformed
  • Other concurrent local symptoms

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Rapid referral to GP within 24 hours*

Signs of systemic infection

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Emergency referral to A&E

N/A

*The pharmacist should complete a referral note for the patient to hand to the surgery detailing why the patient was unable to be treated under the MAS

Version 1.0 29/10/14