Today I was again reminded how nonsensical some OTC combination products are. The thought was sparked by a prescription I received for Hydrozole(R). It's a non-PBS item and can be Pharmacist prescribed. Hydrozole is one of those annoying combination products; hydrocortisone 1% w/w and clotrimazole 1% w/w. According to television advertisements, of which there are many, it's apparently good for sensitive, inflamed skin conditions. I think it's crap, and most texts agree.

You see, if indeed the problem is a fungal infection then treatment, with an azole antifungal is required for 14 days after the lesion resolves (AMH, 2010). Moreover, if the 'rash' is eczematous and a steroid indicated, then a "5 days on, 2 days off" regimen is the usual treatment. Now, it's quite likely that an inflamed fungal infection occurs. And here's the kicker; at every pharmacy I work at, you can get both a steroid cream and an antifungal cream together for less than you pay for hydrozole.

What I suspect happens is that a prescriber is asked about a 'rash', and odds are, it's one of the two. Instead of suggesting the patient purchase one or t'other, they cover their bases and bow to he pressures of 6-minute medicine by writing a 'script; the prescriber's seen the TV adverts, too. I'd be impressed if most prescribers knew the cost of antifungals or steroid creams; I suspect most would pick the combination cream as less expensive. This presents an interesting challenge for those patients who "Just want what's on the prescription."

In short, hydrozole is a medicine that survives on its media profile. It's not appropriate for a simple fungal infection, excessive for an eczematous-type rash and cannot be used to treat anything for the appropriate time. Pretty much, there's no good reason to use Hydrozole(r) and even less reason to prescribe it.