Bacitracin-polymyxin

Systemic therapy with a variety of (3-lactams, macro-lides and lincosamides (clindamycin) has been the cornerstone of skin infection therapy for many years [17]. However, topical antibiotics can play an important role in both treatment and prevention of many primary cutaneous bacterial infections commonly seen in the dermatological practice [18], Indeed, while systemic antimicrobials are needed in the complicated infections of skin and skin structure, the milder forms can be successfully treated with topical therapy alone [18], The topical agents used most often in the treatment of superficial cutaneous bacterial infections are tetracyclines, mupirocin, bacitracin, polymyxin B, and neomycin. 

Gramicidine, Bacitracine, Polymyxine u.a.m. (siehe z.B. Huber und Wallhduser (50)). 

Bacitracin Polymyxin B, Topical (Polysporin) Bacitracin, Neomycin, Polymyxin B, Topical (Neosporin Ointment) Bacitracin, Neomycin, Pol5rm5 xm B, Hydrocortisone, Topical (Cortisporin)... 

C) Triple antibiotics (bacitracin, Polymyxin B, and neomycin) ointment... 

Bacitracin, polymyxin B sulphate, neomycin, gentamicin, gramicidin, mupirocin (T-BACT)... 

Alternatively, antibiotics such as trimethoprim-polymyxin B (Polytrim), gentamicin, or tobramycin solution, instilled as one drop four times daily for 5 to 7 days, or prior generation fluoroquinolones such as ciprofloxacin, ofloxacin, or levofloxacin, dosed four times daily for 5 to 7 days, may be prescribed. Bacitracin-polymyxin B (Polysporin), erythromycin, gentamicin, tobramycin, or ciprofloxacin ointment may be used at bedtime as supplemental therapy or four times daily in children or other patients who are not comfortable with eyedrops. 

Bacitracin is bactericidal for most gram-positive organisms, especially Staphylococcus and Streptococcus species. It is particularly useful when combined with polymyxin B in an ophthalmic ointment. Bacitracin-polymyxin B ointment (Polysporin) provides broad-spectrum antibacterial activity for patients who require nighttime therapy or who are not comfortable with eyedrops. Bacitracin-polymyxin B ointment is particularly effective in the pediatric population because of the high incidence of Streptococcus infection.The usual dose frequency is three to four times daily.Although adverse events are rare, hypersensitivity reactions can occur. Additionally, bacitracin can sometimes be uncomfortable. 

Antibiotic therapy should be limited to periods of disease exacerbation, with the eyelid hygiene providing the daily maintenance regimen. Occasionally, topical erythromycin, bacitracin, or bacitracin-polymyxin B ointment applied at bedtime for several weeks proves beneficial as part of the therapeutic protocol. This type of chronic therapy, however, always carries the risk of fitster-ing overgrowth of resistant organisms. 

Table 7 lists the peptide antibiotics of commercial interest and their producers. Annual U.S. sales of peptide antibiotics, as wholesale price to pharmacies, can be approximated from the following estimates bleomycin, 25 million for 2 kg bacitracin, polymyxin, and gramicidin D, 100 million total for 4 t, 10 kg, and 400 g respectively and cyclosporine, 130 million (3 t). Minor peptides having less than 1 million sales each, such as capreomycin and dactinomycin, are sold at a loss. U.S. agricultural sales figures for bacitracin, 20 million (>200 t), and virginiamycin, 12—15 million (ca 70 t), are indicative of the 1991 market. 

Male, 52 years old, ingested dnring snicide attempt abont 500 mL of canstic soda (Destop ) with splash on the face and neck (Fig. 4.95) and right arm (Fig. 4.96). He came to the bnm center 4 h and a half after the accident. Nothing (water decontamination of the skin) was achieved before hospital admission. Immediately we rinsed skin and month with DIPHOTERINE solntion. The skin lesions of the arm are dressed with snlfadia-zine and the face with bacitracin/polymyxin. 

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