Rogers P J, Wood S M, Garrett E L, Krykant S P, Haddington N J, Hayhurst J, Player G R H
Department of Pharmacy & Pharmacology, University of Bath, Bath BA2 7AY, UK.
Br J Dermatol. 2005 Jun;152(6):1193-8. doi: 10.1111/j.1365-2133.2005.06513.x.
Topical steroids became available, without prescription, in the U.K. in 1987, with hydrocortisone 1% cream first being licensed for irritant contact dermatitis and reactions to insect bites. Since then the number of indications for nonprescription hydrocortisone use has increased and clobetasone has also become available as an over-the-counter (OTC) medicine. Little has been reported about how OTC steroids are used by community pharmacy clients.
We determined how OTC topical steroids are applied by patients, their demographic profile, the products used and the conditions treated, how frequently products were applied and how regularly purchased. The extent to which off-label use takes place was explored.
A patient-completed questionnaire study was used in 100 branches of a national pharmacy in Great Britain.
Questionnaires were completed and returned by 315 clients (16%). Eczema (192 cases, 61%) and dermatitis (66 cases, 21%) were the conditions most frequently treated. Nottingham Eczema Severity Scores calculated for 228 eczema and dermatitis sufferers shows that 164 patients (72%) had mild eczema. Those with more severe eczema were more likely to use clobetasone than hydrocortisone. The use of topical steroids outside OTC marketing authorization guidelines was widespread; however, no patient reported any adverse effects or deterioration in condition following steroid use.
OTC topical steroids are used mainly to treat eczema and dermatitis. Almost 50% of users treating these conditions exceed the limits of the rather restrictive OTC marketing authorization. Clinicians should be aware of the potential for adverse effects as a result of patients self-medicating with hydrocortisone or clobetasone for an extended period.
1987年，外用类固醇药物在英国无需处方即可获得，1%氢化可的松乳膏首次获批用于治疗刺激性接触性皮炎和蚊虫叮咬反应。从那时起，非处方氢化可的松的适用症数量有所增加，氯倍他松也已成为非处方药。关于社区药房顾客如何使用非处方类固醇药物的报道很少。
我们确定了患者如何使用非处方外用类固醇药物、他们的人口统计学特征、所使用的产品和治疗的病症、产品的使用频率以及购买的规律性。还探讨了超适应证用药的程度。
在英国一家全国性药房的100个分支机构中开展了一项由患者填写问卷的研究。
315名顾客（16%）完成并返回了问卷。湿疹（192例，61%）和皮炎（66例，21%）是最常治疗的病症。对228名湿疹和皮炎患者计算的诺丁汉湿疹严重程度评分显示，164名患者（72%）患有轻度湿疹。湿疹较严重的患者比使用氢化可的松的患者更有可能使用氯倍他松。超非处方销售授权指南使用外用类固醇药物的情况很普遍；然而，没有患者报告使用类固醇药物后出现任何不良反应或病情恶化。
非处方外用类固醇药物主要用于治疗湿疹和皮炎。治疗这些病症的使用者中近50%超出了相当严格的非处方销售授权范围。临床医生应意识到患者长期自行使用氢化可的松或氯倍他松可能产生的不良反应。
