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13.10.3 - 13.10.5 Antibacterial, antifungal preparations

13.10.3 Antiviral Preparations

Aciclovir cream 5%


1. Topical antiviral preparations should only be used if treatment is started early and continued for 5-10 days. Aciclovir is costly and should not be used for trivial lesions.

2. There are doubts over the efficacy of topical aciclovir in the management of recurrent herpes labialis. At best it offers only marginal benefits and then only when started within a few hours of the first prodromal signs of an attack. It should not be prescribed.

3. Shingles: Oral antivirals are expensive and offer only marginal clinical benefits in most patients with shingles. They should be used in cases affecting the eye, and in the immunocompromised. They should be started as soon as possible after the onset of the rash (within 72 hours).


13.10.4 Parasiticidal Preparations

Dimeticone lotion
Malathion aqueous liquid
Permethrin dermal cream


Dimenticone lotion is front line choice for headlice.  A recent RCT reported significantly greater efficacy with dimeticone, with an NNT of 2-3. Treatment with two applications 7 days apart.

•some products for the eradication of head lice infestations are combustible/flammable when on the hair and can ignite and cause serious harm in the presence of an open flame or other source of ignition such as when lighting cigarettes (see MHRA link


13.10.5 Preparations for minor cuts and abrasions

Cetrimide cream
Histoacryl tissue adhesive - for use in eye casualty for corneal perforation (unlicensed product)
Magnesium sulphate paste
Proflavine cream 

For link to BNF section: 13.10 Anti-infective skin preparations