Antibiotic Creams and Ointments - Whta's The Difference
What are Topical Antibiotics?
Topical antibiotics are medications used to inhibit or destroy the growth of bacteria. They usually come in the form of creams or ointments that are applied to the skin.
Below are topical antibiotics commonly used for the skin, including brand names:
Table 1. Topical Antibiotics Used in Dermatology
Topical Antibiotics |
Brand Names |
Bacitracin[1] |
Bacitracin |
Neosporin® (Bacitracin/ Neomycin/ Polymyxin B)[2] |
Neosporin® Original, Triple Antibiotic |
Clindamycin[3] |
Cleocin, Cleocin-T, Clindacin ETZ, Clindacin Pac, Clindacin-P, Clindagel, ClindaMax, Clindesse, Evoclin |
Erythromycin[4] |
Akne-Mycin, Ery, Erygel |
Mafenide[5] |
Sulfamylon |
Mupirocin[7] |
Bactroban, Bactroban Nasal, Centany |
Retapamulin[6] |
Altabax |
Silver sulfadiazine[8] |
Silvadene, SSD, Thermazene |
Sulfacetamide sodium/ sulfur[9] |
APOP, Klaron, Ovace Wash, Seb-Prev Wash |
How Do Topical Antibiotics Work?[10]
- Bacitracin – inhibits cell wall formation by bacteria
- Neosporin®(Bacitracin/Neomycin/Polymyxin B) – interferes with bacterial protein synthesis and cell wall formation
- Clindamycin – inhibits bacterial protein synthesis
- Erythromycin – inhibits bacterial protein synthesis
- Mafenide – interferes with bacterial folic acid synthesis
- Mupirocin – inhibits bacterial protein synthesis
- Retapamulin – inhibits bacterial protein synthesis
- Silver sulfadiazine – acts against bacterial cell wall and cell membrane
- Sulfacetamide – inhibits bacteria’s ability to make folic acid
What Conditions Do Topical Antibiotics Treat?[10]
Table 2. FDA-Approved Uses of Antibiotic Medications
Topical Antibiotic |
Skin Conditions |
Other Conditions |
Bacitracin |
Secondary bacterial skin infections |
|
Neosporin® (Bacitracin/ Neomycin/ Polymyxin B) |
Prevention and treatment of skin infection in mild cuts |
|
Clindamycin |
Acne |
Bacterial vaginosis |
Erythromycin |
Acne |
|
Mafenide |
Mafenide cream for treatment of patients with second and third-degree burns, or used on moist dressings over skin grafts for burns |
|
Mupirocin |
-Eradication of nasal colonization with MRSA -Impetigo -Secondary bacterial skin infections
|
|
Retapamulin |
Impetigo |
|
Sulfacetamide lotion |
-Acne -Dandruff -Seborrheic dermatitis -Secondary bacterial skin infection |
|
Silver sulfadiazine |
Prevention of wound sepsis in second and third-degree burns |
|
How Are Topical Antibiotics Given?
Topical antibiotic medications are typically given as a cream or ointment that is applied to the skin. Topical antibiotics are often used daily for one to two weeks but sometimes require repeat treatments. Certain topical antibiotics are also given in the form of shampoo and body wash to treat conditions such as dandruff.
Common Side Effects and Risks of Topical Antibiotics
Table 3. Most Common Side Effects of Topical Antibiotics
Topical Antibiotics |
Side Effects |
Bacitracin |
Skin redness, burning, anaphylaxis (rare) |
Neosporin® (Bacitracin/ Neomycin/ Polymyxin B) |
Skin redness, allergic contact dermatitis, itching, slow healing, anaphylaxis |
Clindamycin |
Xeroderma, oily skin, erythema, skin burning, peeling, itching |
Erythromycin |
Skin peeling, redness, itching, fissuring around the mouth, skin tenderness, dryness, and burning at site of application |
Mafenide |
Facial edema, skin rash, and redness, hyperchloremia, diarrhea, bone marrow suppression, blisters and pain, hyperventilation, tachypnea, hypersensitivity |
Mupirocin |
Headache, skin burning, itching, rash, nausea, rhinitis, congestion, hypersensitivity |
Retapamulin |
Headache, atopic dermatitis, diarrhea, skin irritation, itching |
Silver sulfadiazine |
Erythema multiforme, pruritus, skin photosensitivity, discoloration, rash, agranulocytosis, aplastic anemia, hypersensitivity reaction, interstitial nephritis |
Sulfacetamide |
Skin burning, stinging, Stevens-Johnson syndrome, hypersensitivity reaction, fulminant hepatic necrosis; contraindicated in people with known “sulfa” allergy |
References
- FDA. Bacitracin Ointment. Link to research.
- FDA. TRIPLE ANTIBIOTIC. Link to research.
- FDA. Clindagel. Link to research.
- FDA. ERYTHROMYCIN; Link to research.
- FDA. Sulfamylon. Link to research.
- FDA. Altabax. Link to research.
- FDA. Bactroban Ointment; Link to research.
- FDA. Silvadene; Link to research.
- Link to research.
- Drucker CR. Update on topical antibiotics in dermatology. Dermatol Ther.2012;25(1):6-11; PMID: 22591495.