This paper describes the development of evidence-based protocols for the recognition and treatment of skin sepsis in nurse (RN)-led school clinics in South Auckland, including provision of antibiotics under delegated standing orders. An algorithm for diagnosis of skin infections was adapted from Steer et al. (Bull World Health Organ. 2009;87:173-9). The targeted skin infections include impetigo, cellulitis, scabies and infected eczema. The algorithim recommends fusidic acid ointment as first-line treatment for localised impetigo and twice-daily oral cephalexin for extensive impetigo and cellulitis, for palatability and simplicity of dosing. In the first 15 weeks of a pilot study, 56 school students diagnosed with one or more skin infections were treated under standing orders.
