Preventing prescribing of antibiotics for peristomal moisture-associated skin damage (P-MASD)

Abstract

People living with a stoma may, at some point in their stoma journey, experience peristomal skin complications (PSCs). The majority of PSCs occur as a result of leakage of stomal output onto the peristomal skin, which often results from poor templating or selection of stoma appliance. PSCs typically manifest as hot, red, sore and weepy skin. The symptoms can be misinterpreted as signs of infection, and, as a consequence, professionals may incorrectly prescribe a systemic or topical antibiotic. This is especially problematic, as overuse of antibiotics has been leading to greater bacterial resistance to these treatments, and it is increasingly emphasised that they should not be prescribed unless absolutely necessary. However, an experienced clinical nurse specialist in stoma care should be able to correctly diagnose a PSC, prescribe the appropriate treatment and resolved the problem quickly, without the use of antibiotics.