The medical community keeps encountering bacterial infections that are resistant to (what used to be) some of our most potent antibiotics. AIUI, this is due to overuse (and casual use) in the past. These days, antibiotics are supposed to be prescribed only for bacterial infections, and only for those that appear to be beyond the ability of the body to safety handle on its own. (Lemme know if I’m wrong about any of this.)
With that in mind, I’m wondering why I can go down to the drugstore and buy Neosporin and other OTC antibiotics without a prescription. Most of the time you don’t really need such things: wash your wound, maybe put a bandaid on it, and relax, you’ll be fine. Is the risk of fostering resistant bacteria unusually low for the particular antibiotics in Neosporin and its generic equivalents? Or is the continued sale of OTC antibiotic ointments going to someday come back and bite us in the ass?
The antibiotics in topical preparations aren’t used much in other settings because they only come in IV form and have some pretty nasty side effects like hearing loss, kidney toxicity and neurotoxicity when used that way. There’s generally better and safer choices for whatever bacteria you’re trying to target.
The problem comes from over-use of antibiotics in animals.
Specifically, the routine inclusion of antibiotics in the feed for healthy food animals. (Because the animals grow & gain weight faster, probably because the antibiotics prevent any minor infections in the animal.) This excessive use in otherwise healthy animals kills off the more common infectious germs, leaving the field open for resistant ones to reproduce & spread. Thus making them more common in the human environment.
There aren’t very many forms of viral skin infection, but there are plenty of bacterial skin infections so a short (usually just a couple of days until the wound is no longer red and oozing) use of neomycin, polysporin, or similar topical antibiotic isn’t anywhere near as much of a concern as someone being able to self-diagnose and buy a bottle of azithromycin or methicillin for a common cold or flu, neither of which will be helped with ABX.
Bacterial resistance to topical ABX in ordinary, immunocompetent people just isn’t a thing. From The Role of Topical Antibiotics in Dermatologic Practice (J.J. Leyden, MD)
Actually, this is why we don’t have topical penicillin - resistance, and also an increased risk of allergy. This was discovered very quickly and those items were discontinued.