Antibiotics topical

The principal OTC pharmaceutical products include cold remedies, vitamins and mineral preparations, antacids, analgesics, topical antibiotics, antiftingals and antiseptics, and laxatives. Others include suntan products, ophthalmic solutions, hemorrhoidal products, sleep aids, and dermatological products for treatment of acne, dandmff, insect parasites, bums, dry skin, warts, and foot care products (11). More recent prescription-to-OTC switches have included hydrocortisone, antihistamine and decongestant products, antiftingal agents, and, as of 1995, several histamine H2-receptor antagonists. 

Topical antibiotics exert a direct local effect on specific microorganisms and may be bactericidal or bacteriostatic. Bacitracin (Baciguent) inhibits the cell wall synthesis. Bacitracin, gentamicin (G-myticin), erythromycin (Emgel), and neomycin are examples of topical antibiotics. These drugp are used to prevent superficial infections in minor cuts, wounds, skin abrasions, and minor burns. Erythromycin is also indicated for treatment of acne vulgaris. 

What reaction could occur with prolonged use of the topical antibiotics ... 

When treating acne vulgaris, topical and systemic therapies (if indicated) are initiated 2 to 4 weeks prior to peeling. Topical antibiotics and benzoyl peroxide based products can be used daily and discontinued 1 or 2 days prior to peeling. However, unless a deeper peel is desired, retinoids should be discontinued 7-10 days prior to salicylic acid peeling. Broad-spectrum sunscreens (UVA and UVB) should be worn daily (see Photo damage. Sunscreen section). 

Mupirocin is a topical antibiotic that inhibits isoleucyl tRNA synthetase with the subsequent inhibition of protein synthesis. Mupirocin has become a mainstay in the treatment of Staph, aureus infection and colonization during hospital outbreaks, and it is in this organism that acquired resistance has arisen (Gilbart etal. 1993). 

Less severe infections may be treated with topical antibiotic cream, although this practice is controversial. Oral antibiotics... 

The choice of topical antibiotic in patients who wear contact lenses must cover Pseudomonas aeruginosa. 

Many broad-spectrum topical antibiotics are approved to treat acute bacterial conjunctivitis (Table 60-2). Trimethoprim /polymyxin... 

Treat hyperacute bacterial conjunctivitis with a single dose of 1 g of intramuscular ceftriaxone in combination with topical antibiotics.11... 

Patients with chronic bacterial conjunctivitis often have a concurrent case of blepharitis. Add a lid hygiene regimen to topical antibiotic treatment.12... 

Significant improvement of acute bacterial conjunctivitis should be seen within 1 week.11 Terminate treatment with topical antibiotics when the inflammation is resolved.12... 

Topical antivirals are not used to treat adenovirus conjunctivitis. Topical antibiotics are often prescribed for viral conjunctivitis, ostensibly to prevent bacterial superinfection. In reality, this is a case of the patient insisting on a medication to speed healing.11 Avoid the use of antibiotics for a viral infection.12 Eliminating superfluous antibiotic use also helps prevent the development of antibiotic resistance. 

Topical antibiotic drops are preferred. Consider subconjunctival antibiotics if compliance is a concern. Systemic therapy is useful in cases of systemic infection (e.g., gonorrhea) or if the sclera is infected. Reserve ointments for minor cases or adjunctive nighttime therapy.19... 

Folliculitis, furuncles, and carbuncles refer to the inflammation of one or more hair follicles, often attributed to infection with S. aureus. Treatment depends on severity and may involve local heat, incision and drainage, and/or oral or topical antibiotic therapy. 

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. 

Mild superficial infections, such as those that present clinically with delayed wound healing or minimal cellulitis, may be treated with topical antimicrobial agents.37 Table 70-9 lists some frequently used systemic and topical antibiotics. 

In addition to ANP where it is associated with GI dys-motility [198, 199], SIBO is present in a significant proportion of patients with chronic pancreatitis [200, 201], Short-term rifaximin therapy was able to normalize the hydrogen breath test and improve symptoms (i.e. diarrhea and fecal fat excretion) in all patients studied (fig. 9) [201]. Bowel decontamination via administration of this topical antibiotic could, therefore, be beneficial in both acute and chronic pancreatitis. Double-blind, placebo-controlled studies are to be performed to explore the rifaximin potential in this indication. 

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. 

These data, taken together, demonstrate that topical application of rifaximin represents an effective and safe treatment of pyogenic skin infections. An additional application of this dermatological formulation would be infection prophylaxis in superficial skin wounds, particularly when used with a dressing that occludes the wound. Prophylactic topical antibiotic use makes particular sense for wounds in which the risk of infection is high, such as those that are likely to be contaminated (accidental wounds, lacerations, abrasions, and burns). Because all traumatic wounds should be considered contaminated, topical antibiotics are a logical measure to prevent wound... 

Update on topical antibiotic therapy Changing antibiotic susceptibility patterns and clinical implications. Proceedings from a clinical roundtable. November 9,2002, Scottsdale, Arizona, USA. Cutis 2003 71(3 suppl) 2-24. 

Rafanelli A, Rafanelli G, Palazzini E Effectiveness and safety of a new topical antibiotic cream for use in patients with bacterial skin infection. Prog Rep (Rome) 1993 5 21-29. 

Morris SD, Rycroft RJ, White IR, Wakelin SH, McFadden JP Comparative frequency of patch test reactions to topical antibiotics. Br J Dermatol 2002 146 1047-1051. 

Dire DJ, Coppola M, Dwyer DA, Lorette JJ, Karr JL Prospective evaluation of topical antibiotics for preventing infections in uncomplicated soft-tissue wounds repaired in the ED. Acad Emerg Med 1995 2 4-10. 

See Table 47-4 for systemic treatment of an infected pressure sore. A short, 2-week trial of topical antibiotic (silver sulfadiazine or triple antibiotic) is recommended for a clean ulcer that is not healing or is producing a moderate amount of exudate despite appropriate care. 

A 25% sulfacetamide sodium ointment is needed for certain topical antibiotic activity. In what proportion may 40%, 30%, and 10% sulfacetamide sodium ointments be mixed in order to prepare a mixture of 25% concentration ... 

Mupirocin (Bactroban) Topical antibiotic Oint 2% [15,30gm] Nasal oint 2% [1 gm] Apply to affected areas tid. Active against gram positive cocci 0.5 gm ( 4 tube) in each nostril bid x 5daysfor MRSA nasal carriers... 

---