The incidence of topical steroid dilutions

A survey of the prescribing pattern of topical treatment in a Family Practitioner Committee District revealed that 49.6% of topical preparations contained steroids and of these 11.2% were for diluted products. The majority (84%) of prescribed steroid dilutions on general practice prescription forms (F.P. 10's) were for Betamethasone-17-valerate and 83% required unrecommended diluent. The survey also revealed occasional prescriptions for high dilutions (e.g. 1 in 100 Betnovate) and unreported mixtures (e.g. Betnovate with Coal tar paste and antifungal proprietary creams mixed with steroid proprietaries). The examination of hospital prescriptions forms (F.P. 10 H.P.'s) was used to partially confirm the hypothesis that the practice of dilution and compounding of topical steroids is initiated in hospital and extrapolated to general practice.