News22 mins ago
Neosporin Bacitracina - Sqad ?
16 Answers
Hi sqad
I saw you refer to Neosporin on another thread - it seems very similar to the Bacitracina ointment which is so useful as an OTC (in Portugal) treatment for insect bites and similar skin problems?
I thought all antibiotic (as opposed to antiseptic) creams and salves were now POM in the UK as part of the campaign to reduce the rise of antibiotic resistance?
Neosporin seems to be available via some eBay sellers - but it seems not from the mainstream pharmacies now - do you know what the actual legal position is (you may have access to some sites that are not available to me now)?
I certainly stocked up with Bacitracina in Portugal (about €9 a tube from my friendly pharmacy) - it's saved a couple of visits to the urgent care centre already.
Cheers
Dave xx
I saw you refer to Neosporin on another thread - it seems very similar to the Bacitracina ointment which is so useful as an OTC (in Portugal) treatment for insect bites and similar skin problems?
I thought all antibiotic (as opposed to antiseptic) creams and salves were now POM in the UK as part of the campaign to reduce the rise of antibiotic resistance?
Neosporin seems to be available via some eBay sellers - but it seems not from the mainstream pharmacies now - do you know what the actual legal position is (you may have access to some sites that are not available to me now)?
I certainly stocked up with Bacitracina in Portugal (about €9 a tube from my friendly pharmacy) - it's saved a couple of visits to the urgent care centre already.
Cheers
Dave xx
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The OTC purchase of Neosporin in the the UK is forbidden. The substance is a mix of Zinc Bacitracin, Polymixin B and Neosporin Sulphate, all of which are not permitted for sale as far as UK pharmacies are concerned.
Whilst there are some circumstances under which the antibiotic cream may well be useful, it's as well to remember that its indiscriminate use contributes to bacterial resistance to antibiotics throughout the world. Currently in the USA, there is a variety of MRSA that has led to limb amputation in some patients and the FDA are putting it down to indiscriminate use of Neosporin ointment, which can readily be bought in grocery stores and drugstores.
Yes, Neosporin ointment and variants can be purchased on ebay etc, but I think you need to remember that the reason the antibiotics contained in the product have largely fallen into disuse is because they have been shown to be nephrotoxic and neurotoxic to humans. Acceptance of this toxicity is greater in the UK than in the USA at present and unfortunately, this is one of the reasons why back-door imports of the stuff are available.
In the USA, the public are literally taking their life in their hands by applying this stuff to every graze, pimple and boil. I work in the US for a few weeks every year and I have first-hand experience of the how the stuff is regarded over there. Be very careful.
Whilst there are some circumstances under which the antibiotic cream may well be useful, it's as well to remember that its indiscriminate use contributes to bacterial resistance to antibiotics throughout the world. Currently in the USA, there is a variety of MRSA that has led to limb amputation in some patients and the FDA are putting it down to indiscriminate use of Neosporin ointment, which can readily be bought in grocery stores and drugstores.
Yes, Neosporin ointment and variants can be purchased on ebay etc, but I think you need to remember that the reason the antibiotics contained in the product have largely fallen into disuse is because they have been shown to be nephrotoxic and neurotoxic to humans. Acceptance of this toxicity is greater in the UK than in the USA at present and unfortunately, this is one of the reasons why back-door imports of the stuff are available.
In the USA, the public are literally taking their life in their hands by applying this stuff to every graze, pimple and boil. I work in the US for a few weeks every year and I have first-hand experience of the how the stuff is regarded over there. Be very careful.
Prof.......it is difficult to see how an antibiotic cream can be nephrotoxic as skin absorption into the blood stream is so poor. I can easily visualize oral and parenteral administration is far more likely to affect the kidneys, depending upon dose and length of time it is used.
The question was about an infected toenail which if antibiotics are required ( which is questionable in this case) then the safest route from the point of view of nephrotoxicity and bacterial resistance would surely be by the topical route .
The question was about an infected toenail which if antibiotics are required ( which is questionable in this case) then the safest route from the point of view of nephrotoxicity and bacterial resistance would surely be by the topical route .
No 237SJ, Panton–Valentine leukocidin (PVL) is the name of a cytotoxin present in many strains of MRSA. PVL is not a type of MRSA.
The one I was thinking of has the lovely name FGE strain type USA300 (multilocus sequence type 8, clonal complex 8, staphylococcal cassette chromosome mec type IV). It simply rolls off the tongue, but you did ask!!
I should add though that other strains of MRSA have shown resistance to Neosporin along with other pathogens. The research is ongoing.
The one I was thinking of has the lovely name FGE strain type USA300 (multilocus sequence type 8, clonal complex 8, staphylococcal cassette chromosome mec type IV). It simply rolls off the tongue, but you did ask!!
I should add though that other strains of MRSA have shown resistance to Neosporin along with other pathogens. The research is ongoing.
Thanks theprof. As you know (being in the US) Walgreens and CVS are an Aladdins Cave of drugs and you only have to watch the TV to see dozens of drug ads. Quite scary really. In Bangkok, you can walk into any back street pharmacy and buy antibiotics. I don't know what can be done to stop it really. Nothing, I guess
I couldn't agree with you more Sqad. The toxicity of these compounds have been under investigation for years - a POM aerosol called Cicatrin was popular for the treatment of SA infected carbuncles and suchlike in the sixties and early seventees until it was finally removed from the BNF in 2007. Many of your colleagues reacted with uproar as the dry powder aerosol proved very effective and easily applied by patients or their carers without the need for visits from community nurses.
Nevertheless, it was this toxicity that took it off the market and in the eyes of many medical toxicologists, there is little difference between any form of topical applications of these substances, be they aerosol powder, creams or ointments.
I'm of the belief that judicious, topical use of these antibiotics will cause no harm but the regulatory authorities in the UK maintain that uncontrolled use is potentially dangerous. I always think of the readiness by which Tyrothricin was purchaseable at times like this!
Nevertheless, it was this toxicity that took it off the market and in the eyes of many medical toxicologists, there is little difference between any form of topical applications of these substances, be they aerosol powder, creams or ointments.
I'm of the belief that judicious, topical use of these antibiotics will cause no harm but the regulatory authorities in the UK maintain that uncontrolled use is potentially dangerous. I always think of the readiness by which Tyrothricin was purchaseable at times like this!
237SJ, I called in a Princeton branch of CVS earlier this year when I was making use of my visiting professorship at the university. As you say, just about any drug can be purchased from them over the counter with no questions asked. It's crazy.
It's frightening that these places operate on the principle that the patient knows best what he or she wants. Antibiotic resistance is a real concern and we have already reached a stage where we are using last resort antibiotics for some infections. Goodness knows how effective current antibiotics will be for the next generation.
It's frightening that these places operate on the principle that the patient knows best what he or she wants. Antibiotic resistance is a real concern and we have already reached a stage where we are using last resort antibiotics for some infections. Goodness knows how effective current antibiotics will be for the next generation.
You can buy some variants of Sudafed in the USA without a passport or ID but those are the ones without pseudoephedrine, the crystal meth precursor.
As I understand it, Sudafed Congestion and the prolonged-release (time-release) types are the ones that can only be sold by a pharmacist from behind the counter when they sometimes insist on a passport or other ID. These restrictions have been in place in the US since 2005 with the UK tightening up the regulations three years later.
Every country has different ideas about what drugs should be sold freely to the public and which should be restricted. The issue with Sudafed is that the USA has a bigger problem with crystal meth than we do in the UK, so it seems logical that the restrictions should be tighter with you.
A few years ago, I and mrsprof (she's a medical doctor and a cardiology professor) went over to Ireland by ferry. At the arrival port, she was struck down by a severe headache and we called into the equivalent of one of your Dollar General stores to buy Paracetamol (Acetaminophen/Tylenol) tablets. We were unaware that the analgesic could only be sold in pharmacies in Ireland, whereas it's freely available in grocery stores in the UK, albeit with restrictions on the number that can be purchased.
As I understand it, Sudafed Congestion and the prolonged-release (time-release) types are the ones that can only be sold by a pharmacist from behind the counter when they sometimes insist on a passport or other ID. These restrictions have been in place in the US since 2005 with the UK tightening up the regulations three years later.
Every country has different ideas about what drugs should be sold freely to the public and which should be restricted. The issue with Sudafed is that the USA has a bigger problem with crystal meth than we do in the UK, so it seems logical that the restrictions should be tighter with you.
A few years ago, I and mrsprof (she's a medical doctor and a cardiology professor) went over to Ireland by ferry. At the arrival port, she was struck down by a severe headache and we called into the equivalent of one of your Dollar General stores to buy Paracetamol (Acetaminophen/Tylenol) tablets. We were unaware that the analgesic could only be sold in pharmacies in Ireland, whereas it's freely available in grocery stores in the UK, albeit with restrictions on the number that can be purchased.
Sorry for not replying last night - a couple of pints of Guinness at the Pub Quiz reduced my cognitive abilities a bit.
Thank you all for a very informative thread - AB at its very best.
I think the problem of antibiotic resistance is one that we'll return to again and again - a lot of what I have read indicates that a very large part of the problem lies in the routine (lazy) over-use of antibiotics in animal husbandry - especially in America and its client states in the third-world.
It's not much good us being careful in antibiotic usage if they are being stuffed down the throats of billions of chickens and cows all over the Americas and (especially) South Asia.
Which doesn't mean we shouldn't try, just that I suspect a lot what is done is 'too little, too late' on a global scale.
Thank you all for a very informative thread - AB at its very best.
I think the problem of antibiotic resistance is one that we'll return to again and again - a lot of what I have read indicates that a very large part of the problem lies in the routine (lazy) over-use of antibiotics in animal husbandry - especially in America and its client states in the third-world.
It's not much good us being careful in antibiotic usage if they are being stuffed down the throats of billions of chickens and cows all over the Americas and (especially) South Asia.
Which doesn't mean we shouldn't try, just that I suspect a lot what is done is 'too little, too late' on a global scale.
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