OTC antibiotic cream and bacterial resistance

Bein’ a good citizen and all, I am cautious about antibiotics. I don’t demand them from my doctor, I always take the full course, I shop 'till I drop to find non-antibacterial liquid hand soap (know how hard that stuff is to find?) . . .

But from when my husband had an ingrown toenail we have some OTC antibiotic first-aid-type cream, purchased on the advice of his podiatrist, and I’m wondering whether this stuff should be used with care.

Two guesses:

  1. By using this stuff on my hangnails without professional supervision, I’m breeding antibiotic-resistant staph which will devour my flesh from the fingertips inward until it reaches my brain.

  2. The antibioticis in the cream have been abused so long that they are killing approximately .03% of the bacteria festering in my wounds and I should wash with soap and hot water and use a plain bandaid for the same effects at half the price.

Or, uh, guess number three: I don’t have the first clue what I’m talking about and Dopers with medical expertise will be along soon to explain.

Here are the active ingredients, BTW: polymyxin B sulfate, bacitracin zinc and neomycin sulfate.

All three of the antibiotics in the ingredients are relatively benign and I wouldn’t worry about creating a flesh-eating strain of staph that will soon be devouring your brain matter.

However, that said, rubbing alcohol probably would have been just as effective. The reason that antibiotic ointments are so wide-spread, is the mode of application, and they stay on under a band-aid.

P.S. Finding a non-antibacterial hand soap IS a pain the back-side!

What are you saying, that you’ve got hangnails so bad that they’re all infected? Yeah, it’s probably not a good idea to self-medicate that with OTC antibiotics. They’re meant for one-time use, like for a really bad skinned knee, more of a single-use prophylactic than for any serious ongoing “antibiotic” effect.

The biggest reason IMO to use a dab of antibiotic ointment under a “really bad skinned knee” bandage is that it helps keep the bandage from sticking, for that first day. Then the next day, when you put on a new bandage, you leave off the “gook”, which the kid is usually happy to do anyway (all my kids HATED the “gook”.) It beats merthiolate and iodine, for another thing.

Thanks for not being an antibacterial-using idiot. It’s appreciated.

Polymyxin B sulfate, bacitracin zinc and neomycin sulfate are not given by mouth or injection, they are only used topically, so if you did have, for example, a polymyxin B sulfate- or bacitracin zinc- or neomycin sulfate-resistant staph infection it wouldn’t be such a big deal.

As far as I know, development of resistance to polymyxin B sulfate, bacitracin zinc and neomycin sulfate (which have all been around a long time) is not a big problem compared with development of resistance to systemic agents. This could be because when you take an oral antibiotic you generally saturate your entire body (including your gastrointestinal tract) and all its bacterial inhabitants with the antibiotic whereas when you apply antibiotic topically you just put a teensy bit in one place.

I wouldn’t give medical advice on the internet but I would say that, in general, there is little or no evidence that people with ingrown nails who apply polymyxin B sulfate, bacitracin zinc and neomycin sulfate to their toes suffer adverse consequences due to antibiotic-resistant bacteria.

However, some dermatologist I know discourage the use of neomycin-containing preparations because neomycin can cause allergic reactions. You can buy preparations with polymyxin B sulfate and bacitracin zinc only.

Keep in mind that if an infection is in the tissues, not on the surface, the topically applied antibiotics won’t do a damn thing. (It’s like spraying Baygon on your back door when your problem is roaches in the kitchen.)

LOL

Ok, few pieces of information.

  1. Sulfa drugs (OTC antibiotic creams) have been around since WWII. Don’t worry about using em. Its not like bacteria hasn’t had a chance to get exposed to it in the last 50 years.

The stuff in that cream is sulfa drugs. Like i said they’ve been around forever and they work to prevent the synthesis of the cell wall (rigid wall thingy that keeps the bacterium from exploding).

Sure some bacteria will get resistant to it, but since they are inside and causing an infection (every wound gets infected its just a question of severity) your immune system will clear it. That and in the 50 years we’ve used it we can still use it to kill common infections from cuts and scrapes.
2) Antibiotic soap and stuff.

Two catagories: 1) Crammed full of ethanol… Ethanol is the ultimate antibiotic. Its cheap, easy to make and kills everything… this is the sort of thing we use in the lab I work at. (we actually use 75% reagent grade ethanol mixed in h20)
2) It has trilosan. (spelling) Yet again its been out there for a while, but the thing is its not used for internal treatment (at least I haven’t heard of it being used that way) so if you do use it, it won’t create a strain of bacteria that will impact medical treatments. Worst case, you create a breed of bacteria in your dish rag which isn’t affected by it. Then you throw it out.
The take home message here about the antibiotic cream is that its the easiest way to kill bacteria and is cheap and harmless to humans. Are you making resistant bacteria? Yeah, but you’re killing anything that survive the cream anyway [well if you don’t you’re gonna get bloodpoisoning and die]. I wouldn’t worry about that.
You see, the antibiotic problem comes from stupidity of drug companies.

I would stay away from rubbing alcohol as biological systems don’t react well to denatured ethanol. Another nice aspect of the cream is that it blocks further entry to the wound (more or less) and it also will work its way down into the wound and hopefully kill anerobic bacteria.

What the medical profession is trying to get people to understand is that in the 40 years since we first developed all of these antibiotics (many were isolated from other bacterium that used antibiotics as a method for keeping away competition) more and more things are getting resistant to them. This mainly is the problem where you have a large popultion of bacteria being constantly exposed to antibiotics (aka hospitals). Because of this drug resistant bacteria is being found in hospitals which is bad since people in hospitals have compromised immune systems and deep open wounds (surgery). So what they are trying to do is cut down on the number of antiobiotics they prescribe, and those that are prescribed you need to take to prevent the infection from being partially cleared (and hence leaving some bacteria alive that have been exposed to the drugs alive).

So how does this impact you and the hang nail.

Use the antibiotic cream. Use the antibacterial soap (hell most of it isn’t even antibacterial)

As for your guesses:

1)Flesh eating bacteria has other mutations in it. Antibacteria soap/cream/whatever that you can buy over the counter won’t make it.
2) there is the whole concept of only isolated patches of bacteria will have antibiotic resistance. Unless you work in a hospital or work with large amounts of infectious bacteria and antiobiotics you won’t encounter a sulfa drug resistant strain. The cream will actually kill a lot of the bacteria.

Guess 3)Hell, you’re already several steps ahead of the people who bought all the cipro they could get their hands on. laughs his ass off I can’t imagine the number of people who had allergies and started popping those suckers by the handful.

The problem with cipro is that we only have 1 or 2 antibiotics that will kill heavy duty hospital infections and until we get more drug research done those have gotta last us.

Hope this helped

I’ve got to disagree with you on a couple of points CRorex. Yes sulfa drugs have been used since WWII but they aren’t nearly as effective now as the once were. In fact, when penicillin came about, it was believed that we had bacteria beat with that discovery, but now we can see that overuse of any antibiotic can potentially be harmful.

The antibiotics in her cream are not sulfanilamides.

The effects of triclosan are not well studied. It is not a general antibiotic as ethanol, but it is targeted to a enzyme. Since it is so widely used (especially in the kitchen) bacteria, especially foodborne, have the potential to gain resistance, and therefore pose a medical problem.

As long as you’re not ingesting rubbing alcohol, it should pose no more problem to a hang-nail than any other topical preparation.

Thanks for the informative responses, guys, but I’m disappointed in DDG for not having a Google cite. :wink:

I only use the stuff on really bad hangnails and other deeper boo-boos out of a mostly superstitious belief that it helps them heal faster, and partly because, well, I’ve got the stuff, and I might as well use it up before the expiration date. Now I can use it without fear. :slight_smile: