Antibiotic Creams and Ointments - Whta's The Difference

Which antibiotic ointments are used for skin rashes? 

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/ Neomycin/ Polymyxin B)[2]

Neosporin® Original, Triple Antibiotic


Cleocin, Cleocin-T, Clindacin ETZ, Clindacin Pac, Clindacin-P, Clindagel, ClindaMax, Clindesse, Evoclin


Akne-Mycin, Ery, Erygel




Bactroban, Bactroban Nasal, Centany



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


Secondary bacterial skin infections



(Bacitracin/ Neomycin/ Polymyxin B)

Prevention and treatment of skin infection in mild cuts




Bacterial vaginosis





Mafenide cream for treatment of patients with second and third-degree burns, or used on moist dressings over skin grafts for burns



-Eradication of nasal colonization with MRSA


-Secondary bacterial skin infections






Sulfacetamide lotion



-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


Skin redness, burning, anaphylaxis (rare)


(Bacitracin/ Neomycin/ Polymyxin B)

Skin redness, allergic contact dermatitis, itching, slow healing, anaphylaxis


Xeroderma, oily skin, erythema, skin burning, peeling, itching


Skin peeling, redness, itching, fissuring around the mouth, skin tenderness, dryness, and burning at site of application


Facial edema, skin rash, and redness, hyperchloremia, diarrhea, bone marrow suppression, blisters and pain, hyperventilation, tachypnea, hypersensitivity


Headache, skin burning, itching, rash, nausea, rhinitis, congestion, hypersensitivity


Headache, atopic dermatitis, diarrhea, skin irritation, itching

Silver sulfadiazine

Erythema multiforme, pruritus, skin photosensitivity, discoloration, rash, agranulocytosis, aplastic anemia, hypersensitivity reaction, interstitial nephritis


Skin burning, stinging, Stevens-Johnson syndrome, hypersensitivity reaction, fulminant hepatic necrosis; contraindicated in people with known “sulfa” allergy

* This Website is for general skin beauty, wellness, and health information only. This Website is not to be used as a substitute for medical advice, diagnosis or treatment of any health condition or problem. The information provided on this Website should never be used to disregard, delay, or refuse treatment or advice from a physician or a qualified health provider.


  1. FDA. Bacitracin Ointment. Link to research.
  2. FDA. TRIPLE ANTIBIOTIC. Link to research.
  3. FDA. Clindagel. Link to research.
  4. FDA. ERYTHROMYCIN; Link to research.
  5. FDA. Sulfamylon. Link to research.
  6. FDA. Altabax. Link to research.
  7. FDA. Bactroban Ointment; Link to research.
  8. FDA. Silvadene; Link to research.
  9. Link to research.
  10. Drucker CR. Update on topical antibiotics in dermatology. Dermatol Ther.2012;25(1):6-11; PMID: 22591495.