Recommended Dispensing Amounts for Hydrocortisone 1% Cream and Mupirocin 2% Ointment for Skin Rash
For a skin rash, dispense 15-30g of hydrocortisone 1% cream and 15-30g of mupirocin 2% ointment for treatment of affected areas on the face and neck, with larger amounts needed for other body areas. 1
Dispensing Guidelines Based on Affected Area
The appropriate amount to dispense depends on the location and extent of the rash:
| Area of body | Recommended amount (per 2 weeks) |
|---|---|
| Face and neck | 15-30g |
| Both hands | 15-30g |
| Scalp | 15-30g |
| Groins and genitalia | 15-30g |
| Both arms | 30-60g |
| Both legs | 100g |
| Trunk | 100g |
These amounts are suitable for a single daily application for a 2-week treatment period 1.
Application Instructions
Hydrocortisone 1% Cream
- Apply a thin layer to affected areas 1-2 times daily
- Duration: Short-term use (2-3 weeks) is recommended to avoid skin thinning and other adverse effects 1, 2
- Use cream formulation if the skin is weeping; ointment if the skin is dry 1
Mupirocin 2% Ointment
- Apply a small amount to the affected area three times daily 3
- The area may be covered with a gauze dressing if desired
- Patients should be re-evaluated if not showing clinical response within 3-5 days 3
Treatment Algorithm Based on Rash Severity
For Mild Rash (Grade 1):
- Continue with hydrocortisone 1% cream 1-2 times daily
- Apply mupirocin 2% ointment three times daily if infection is suspected
- Use emollients regularly
- Reassess after 2 weeks 1
For Moderate Rash (Grade 2):
- Continue or increase hydrocortisone application
- Apply mupirocin three times daily for at least 14 days
- Consider oral antibiotics if not responding
- Reassess after 2 weeks; if not improving, consider dermatology referral 1
For Severe Rash (Grade 3):
- Consider higher potency topical steroids
- Continue mupirocin application
- Consider oral antibiotics
- Dermatology referral recommended 1
Clinical Considerations
- Cream formulations are preferred when skin is weeping, while ointments are better for dry skin 1
- For suspected bacterial superinfection, mupirocin has excellent efficacy against Staphylococcus and Streptococcus, which are common skin pathogens 4, 5
- Combined therapy with hydrocortisone and mupirocin has shown better efficacy (74% success rate) compared to hydrocortisone alone (65% success rate) in some studies 6
- Mupirocin cream has similar or superior efficacy to oral antibiotics in treating skin infections 7
Common Pitfalls to Avoid
- Dispensing insufficient amounts leads to inadequate coverage and treatment failure
- Prolonged use of topical steroids (beyond 2-3 weeks) can cause skin thinning and other adverse effects
- Missing underlying infections that may be masked or exacerbated by steroids 2
- Continuing to increase steroid potency when no response is seen 2
- Failing to obtain bacterial cultures when infection is suspected and not responding to topical antibiotics 1
If the rash does not improve within 2 weeks of appropriate treatment, reassessment and possibly dermatology referral should be considered 2.