clotrimazole

Context

Pharmacy First

This codelist is designed for use in Pharmacy First context to capture prescribing of clotrimazole formulations used in the management of superficial fungal infections, particularly cutaneous and vulvovaginal candidiasis (control for uti).

Inclusion/exclusion criteria

We included clotrimazole topical formulations including creams, pessaries, and sprays, where clotrimazole is the active antifungal ingredient. These formulations are commonly used in the treatment of fungal skin infections and vulvovaginal candidiasis in primary care.

We excluded combination products containing betamethasone and clotrimazole, including betamethasone dipropionate 0.064% / clotrimazole 1% cream (VMP) and its corresponding VTM. These were excluded to ensure the codelist captures antifungal monotherapy only and avoids confounding with topical corticosteroid-containing preparations. We also excluded : Canesten AF Dual Action 1% powder (Bayer Plc) (AMP) (607211000001103, Canesten AF Dual Action 1% spray (Bayer Plc) (AMP) (3693511000001104), Canesten Athlete's Foot 1% cream (Bayer Plc) , Canesten Dermatological 1% powder (Bayer Plc) (AMP) (621311000001108), Canesten Dermatological 1% spray (Bayer Plc) (AMP) (3693111000001108), Clotrimazole 1% powder (Special Order) (AMP) (29861511000001106), Clotrimazole 1% powder (VMP) (36089611000001101), Clotrimazole 1% solution (VMP) (41784411000001103), Clotrimazole 1% spray (VMP) (41784511000001104), Galpharm Athletes Foot 1% cream (Galpharm International Ltd) (AMP) (18746511000001106) and Lloydspharmacy Athletes Foot 1% cream (Lloyds Pharmacy Ltd) (AMP) (7907411000001101) as they are for other candida infections, not vaginal thrush.

Borderline cases

Combination use with fluconazole was considered borderline. These combinations were included where they reflect real-world prescribing patterns for vulvovaginal candidiasis, where systemic fluconazole may be used alongside topical clotrimazole formulations as part of dual therapy. Inclusion was based on relevance to GP treatment pathways rather than strict monotherapy (especially in GP practices).

Sensitivity vs specificity

This codelist is sensitive, aiming to capture a broad range of clotrimazole prescribing across multiple formulations (cream, pessary, spray). The inclusion of combination use with fluconazole further supports completeness of antifungal exposure capture within general practice.

Additional information

Clotrimazole is a broad-spectrum imidazole antifungal used in both dermatological and vaginal infections. The codelist is structured using dm+d hierarchy to ensure consistent identification across formulation types.