Topical Antibiotics

What are topical antibiotics?

Topical antibiotics are antibacterial medications you put somewhere on the outside of your body. Some of these come in over-the-counter (OTC) forms, but most are available with a prescription only.

Antibiotics are medications that kill bacteria directly or stop the bacteria from reproducing. Either way, the bacteria die out, which stops the infection. Topical antibiotics are only good for bacterial infections. They don’t help other kinds of infections.

The topical route for antibiotics works a little differently than the oral, IV or injection routes. Instead of going everywhere in your body like with those other routes, topical antibiotics stay where the infection is.

One way to organize topical antibiotics is by where they go. Those are:

• Dermal (for skin infections). These usually come in thicker forms like ointments, creams or gels. Some come in wearable patches, and your skin absorbs the medications over time. Some bandages or wound dressings even come with antibiotics included in their material.
• Ophthalmic (for eye infections). These usually come in various forms of eye drops, but there are some eye ointments, too. Your eyes can usually absorb medications in these forms very quickly.
• Otic (for ear infections). These generally come in ear drop form.

What are the advantages of topical antibiotics?

Some advantages of topical antibiotics include:

• They treat infections directly. Delivering the medication right at the site of the infection is more efficient.
• They avoid some side effects. Diarrhea or other forms of digestive tract upset are common with many oral antibiotics. Topical antibiotics don’t have this effect.
• They can stop infections early. Keeping infections from spreading and becoming more serious is a major benefit.

What are the disadvantages of topical antibiotics?

Some disadvantages of topical antibiotics include:

• Some have limited effectiveness. Over-the-counter topical antibiotics aren’t usually effective against many types of common bacteria. But prescription topical antibiotics are usually much more effective.
• They have a risk of side effects. Many topical antibiotics, especially common over-the-counter ones, can cause irritation or reactions.

Over-the-counter topical antibiotic products often include medications like bacitracin, neomycin or polymyxin B. But medical providers often recommend using petroleum jelly (formally known as petrolatum) instead of these antibiotics. Petroleum jelly is just as effective as OTC products containing those antibiotics, and it has a lower risk of causing reactions.

How can I take care of myself after treatment with topical antibiotics?

If a provider prescribes topical antibiotics, it’s important to use these medications exactly as instructed. That includes finishing the medication. You shouldn’t stop taking medications partway without first talking to your provider and making sure it’s safe to do so. Stopping topical antibiotics when you feel better, but before you finish the medication, can allow the infection to return. It also increases the risk of bacteria developing resistance to medications.

Can I use topical antibiotics meant for one part of my body elsewhere?

You should only use topical antibiotics exactly as prescribed. While you might have heard you can use some of these medications interchangeably, it’s not safe to do so. That means use eye drops only on your eyes, ear drops only on your ears, and skin products only on your skin.

When should I see my healthcare provider?

You should call or see your healthcare provider if:

• Treatment doesn’t seem to be helping and/or the infection is getting worse
• You’re experiencing side effects, especially ones that disrupt your life or make it difficult to take your medication
• The infection returns after you finish taking prescribed treatments

If you have any symptoms of a spreading infection or sepsis, you need immediate medical attention. Sepsis is a medical emergency like a stroke or a heart attack, so call 911 or your local emergency services number right away.