Topical Antibiotic

Aka: Topical Antibiotic

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II. Medications

  1. Bacitracin Zinc
    1. Indicated for use on minor open wounds, Burn Injury and Skin Abrasions
    2. May speed Wound Healing (retains moisture within the wound, preventing eschar)
      1. When antibiotics are not indicated, consider bland topicals (e.g. aquaphor) instead
    3. Apply one to three times daily
    4. Risk of Contact Dermatitis
    5. Bacitracin Zinc is preferred over "triple antibiotic" (Neomycin/polymyxin B/Bacitracin)
      1. Triple Antibiotic ointment has a greater risk of Contact Dermatitis, without significant added benefit
  2. Mupirocin (Bactroban) 2% ointment
    1. Impetigo: Applied three times daily to affected area for 7-10 days
    2. May be used in age 2 months and older
    3. Available as 22 g tube (ointment is less expensive than creams)
    4. Emerging Streptococcal resistance in 2014
  3. Retapamulin (Altabax) 1% ointment
    1. Impetigo: Apply twice daily to affected area for 5 days
    2. May be used in age 9 months and older
    3. Treatment area must be <100 cm2 (or <2% total BSA in children)
  4. Fusidic Acid 2% cream (Not available in United States)
    1. Impetigo: Apply three times daily to affected area for 10-12 days
    2. Koning (2002) BMJ 324:203-6 [PubMed]

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