Antibiotic ointments

After the tape mask removal the exudate is cleaned by sterile saline. Spot peeling and retaping may be done if the skin looks underpeeled, particularly in areas with severe wrinkling. It is usually accompanied by a short-duration burning sensation. The tape is left for an additional 4-6 h and then removed by the patient. We cover the face with bismuth subgalate antiseptic powder for 7 days (Fig. 8.10). Other options include occlusive moisturizers, antibiotic ointments, and biosynthetic occlusive dressings such as Meshed Omiderm. 

Antibiotic ointment (medium/deep three to five times a day)... 

However, local anesthetics may be helpful when abrasion accompanies the injury.39 Application of an over-the-counter antibiotic ointment containing an anesthetic may provide soothing relief, promote healing of abrasions, and prevent soft-tissue infection. Minor abrasions should be cleansed thoroughly with mild soap and water before application. More severe abrasions may require removal of debris or foreign bodies by a clinician followed by irrigation with normal saline. 

A topical antibiotic or antifungal may be used to control the spread of infection but generally is unnecessary. For staphylococcal or streptococcal folliculitis, antibiotic ointments such as mupirocin might be administered three times daily. Antifungal shampoo can be used for dermatophytes. 

For prophylaxis of ophthalmia neonatorum, various groups have proposed the use of erythromycin (0.5%) or tetracycline (1%) ophthalmic ointment in lieu of silver nitrate. Although silver nitrate and antibiotic ointments are effective against gonococcal ophthalmia neonatorum, silver nitrate is not effective for chlamydial disease and may cause a chemical conjunctivitis. 

Topical Local effects on surface of skin Only effective in treating outer layers of skin Antibiotic ointments creams used to treat minor skin irritation and injury... 

Inorganic silver salts are strongly bactericidal. Silver nitrate, 1 1000, has been most commonly used, particularly as a preventive for gonococcal ophthalmitis in newborns. Antibiotic ointments have replaced silver nitrate for this indication. Silver sulfadiazine slowly releases silver and is used to suppress bacterial growth in burn wounds (see Chapter 46 Sulfonamides, Trimethoprim, Quinolones). 

Monitor the animal until it recovers from the anesthetic and is moving freely around the cage. Place a water bottle filled with children s Tylenol on the cage and allow the mouse free access to the solution for the first 2 days of recovery. If the scalp wound becomes infected, apply a topical antibiotic ointment. 

Topical antibiotics are typically available as ointments and are excellent for use on open wounds. Coupled with the antibacterial action of the antibiotic ingredient, topical antibiotic ointments provide a safe and effective option in wound healing. In addition, topical antibiotics are effective for the localized treatment of primary and secondary pyodermas with minimal systemic side effects.14 Prophylactic uses include application for traumatic and surgical wounds, burns, intravascular catheters, and eradication of S. aureus nasal carriage.16 42 The advantage of antibiotic therapy in the treatment of eczematous skin will be discussed in the following article considering AD as an example. 

Blister/vesicant exposure is treated primarily as a thermal burn. Sulfur mustard decontamination is limited to immediate washing of exposed skin with water or soap and water, and flushing the eyes with copious amounts of water. Avoid 0.5% sodium hypochlorite solution or vigorous scrubbing as they may cause deeper tissue penetration. Typical burn therapy is accomplished with antibiotic ointment, sterile dressing, and other supportive... 

Application of solutions or ointments directly to the lid margin is especially helpful in treating seborrheic or infectious blepharitis. After several drops of the antibiotic solution or detergent, such as baby shampoo, are placed on the end of a cotton-tipped appUcator, the solution is applied to the Ud margin with the eyeUds either opened or closed (Figure 3-11). Antibiotic ointments are applied in the same way. 

A fixed-combination ointment containing oxytetracy-cline and polymyxin B is available for topical ocular use (see Table 11-6). The Centers for Disease Control and Prevention recommends ophthalmic ointments containing a tetracycline or erythromycin as an effective alternative to silver nitrate for prophylaxis of gonococcal ophthalmia neonatorum. A major advantage of using an antibiotic ointment such as oxytetracycline-polymyxin B is that it does not canse the chemical conjunctivitis typically produced by silver nitrate. 

Once local anesthesia has been verified, the lesion should be grasped with tissue forceps and removed at the base using a scalpel, iris scissors, or Westcott scissors.The excised lesion should be placed in a vial of fixative and sent to the laboratory for pathologic evaluation. Hemostasis should be maintained with direct pressure using a cotton swab, or bleeding vessels should be cauterized with a disposable cautery. An antibiotic ointment... 

Lid hygiene consists of hot compresses, lasting 5 to 10 minutes and performed two to four times daily, followed by lid scrubs using a mild detergent cleanser such as baby shampoo and a washcloth or prepackaged commercially available lid scrubs (Box 23-2). Dilution of the shampoo is not necessary imless the patient has an unfavorable reaction to full strength. The hot compresses serve to loosen lid debris and dilate blood vessels to allow increased blood flow to the area. The scrubs not only facilitate removal of debris but also serve to lyse bacterial membranes and to reduce the bacterial load. Antibiotic ointment should then be applied directly to the lid margin two to foiu- times daily. Antibiotic drops are used when a secondary conjunctivitis is also present. 

Associated toxic epithelial keratitis should respond to blepharitis treatment. Topical steroids are generally not required imless the cornea is significantly involved or a phlyctenule is present. In this case prednisolone 0.12% used two or three times a day for a few days may be used. Combination steroid-antibiotic ointments, such as tobramycin-dexamethasone or the topical combination drop tobramycin-loteprednol, may prove to be useful for those patients complaining of excessive itching and burning. Steroids control the hypersensitivity component that is often present and reduce the congestion and irritation that often provoke the patient to rub the eye and aggravate the blepharitis. 

In resistant cases of seborrheic blepharitis, bacterial superinfection must be considered and an antibiotic ointment may be added to the regimen if indicated. 

The eyelids are very vascular and are very forgiving, and secondary infection after an eyelid procedure is rare. However, an application of antibiotic ointment is gently applied to the area and is prescribed foim times a day for 3 days. It is important to inform the patient that the eyelid is going to look worse immediately after the procedure than it did before the procedure.The trauma created by the injections, the clamp tightening, and the incision and curettage make the lid appear swollen. By the next day the lid will be markedly improved in appearance. There should be total resolution of the lesion within 2 to 3 weeks with no evidence of the procedure. Pain after the procedure and after the anesthetic wears off is virtually nonexistent. If there is discomfort, ibuprofen is prescribed for pain control. 

When patients are suspected of having underlying staphylococcal disease, both inflammatory and bacterial components can be managed with a steroid-antibiotic combination. Initial doses should be administered every 2 to 4 hours, depending on severity, for the first 24 to 48 hours. In most instances, patients obtain dramatic relief from symptoms and can diminish use of the drug in 7 to 10 days. Because of the association of Staphylococcus with eyelid disease, lid therapy should be instituted. Antibiotic ointments such as erythromycin, bacitracin,... 

Some practitioners prefer not to recommend the use of therapeutic soft contact lenses during episodes of bullae eruption. When a patient presents with corneal epithelial defects due to ruptured bullae, a prophylactic antibiotic ointment such as 0.3% tobramycin or 0.3% ciprofloxacin four times a day can be administered, along with a cycloplegic agent (e.g., 5% homatropine two times a day). 

Small corneal abrasions typically heal quickly (24 to 36 hours). Topical prophylactic antibiotic therapy protects the disrnpted corneal epithelium from secondary infection as the tissne heals. Broad-spectrum ophthalmic antibiotic drops, snch as 0.3% tobramycin or 0.5% moxi-floxacin, may be instilled four times daily, along with a broad-spectrnm antibiotic ointment such as 0.3% tobramycin or 0.3% ciprofloxacin instilled at bedtime. Prophylactic topical antibiotic therapy can be discontin-ned once the corneal epithelium has healed. 

During acute episodes a broad-spectrum topical prophylactic antibiotic ointment, such as 0.3% tobramycin or 0.5% moxifloxacin, protects the cornea from secondary infection while it heals. The use of a therapeutic contact lens and topical NSAIDs, such as diclofenac sodium 0.1% solution or ketorolac 0.5% solution, provide symptomatic relief. The therapeutic soft contact lens also protects the regenerating epithelium and temporarily provides epithelial stability. A cycloplegic agent, such as 5% homatropine, should be instilled to decrease ciliary spasm and pain. Oral analgesics can be prescribed as needed (see Chapter 7). The eye should be examined in 24 hours and the therapy continued until the epithelial defect is healed. 

After anterior stromal puncture, PTK, or superficial keratectomy, broad-spectrum topical prophylactic ophthalmic antibiotic drops such as 0.3% tobramycin, 0.3% ciprofloxacin, or one of the newer generation fluoroquinolones, moxifloxacin or gatifloxacin, should be instilled three to four times daily, along with a broad-spectrum antibiotic ointment such as 0.3% tobramycin or 0.3% ciprofloxacin instilled into the conjunctival sac at bedtime. NSAIDs such as diclofenac sodium 0.1% solution... 

Although phlyctenules can resolve spontaneously, they usually ulcerate and scar before resolution. To prevent scarring, treatment should include 1% prednisolone acetate, one drop every 2 to 4 hours for 3 to 4 days. Also, instill prophylactic antibiotic ointment or drops, such as bacitracin, erythromycin, or polymyxin B/trimethoprim, into the conjunctival sac four times a day and continue as... 

Topical corticosteroids are used in cases of exacerbation and should be applied sparingly to the affected area. Hydrocortisone 1% twice a day or dexamethasone 0.1% applied to the periorbital area helps to relieve symptoms during these periods. Secondary infection manifested as blepharitis or keratoconjimctivitis should be treated with topical ophthalmic antibiotic ointments such as bacitracin or erythromycin.Topical antihistamines, NSAIDs, or mast cell stabilizers can be used to control itching, and topical steroids are sometimes required to treat severe keratoconjunctivitis associated with the atopic response. Because of side effects, steroids are not indicated for longterm use. 

Topical antibiotic ointment or topical antibiotic-steroid ointment... 

Berger RS, Pappert AS, Van Zile PS, Cetnarowski WE. A newly formulated topical triple-antibiotic ointment minimizes scarring. Cutis 2000 65(6) 401. ... 

Mild eye lesions require little treatment other than flushing with water immediately. Slow running water is applied as one tilts the head from side to side, pulling the eyelids apart. Steroid and antibiotic ointment can be applied to the eye. 

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