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Antibacterials (Topical)

bacitracin metronidazole (Metrogel ®)
mupirocin (Bactroban ® ) Neosporin ® (bacitracin /neomycin /polymyxin)
Polysporin ® (bacitracin/ polymyxin) silver sulfadiazine (Silvadene ®)

bacitracin: top of page icon

Exerts a profound action against many gram-positive pathogens, including the common Streptococci and Staphylococci. It is also destructive for certain gram-negative organisms. It is ineffective against fungi.

Used to treat or prevent a skin infection.

This medication is for topical use only. Clean and dry the affected area as directed. Then apply a small amount of the medication on the skin. A thin layer is all that is needed. Cover with a bandage if directed to do so. Do not use large amounts, apply this more often or use this for a longer period than directed. Your condition will not clear faster, but the chance for side effects may be increased. Use carefully if applying to the face. Avoid contact in or around the eyes.

Dosing:  Apply 1 to 4 times daily. 

Supplied: [ointment]

metronidazole  (Metrogel ®) top of page icon

INDICATIONS
METROGEL® Topical Gel is indicated for topical application in the treatment of inflammatory papules and pustules of rosacea.


DOSAGE AND ADMINISTRATION
Apply and rub in a thin film of METROGEL® Topical Gel twice daily, morning and evening, to entire affected areas after washing.

Areas to be treated should be cleansed before application of METROGEL® (metronidazole topical gel) Topical Gel. Patients may use cosmetics after application of METROGEL® Topical Gel.

The mechanisms by which METROGEL® (metron-idazole topical gel) Topical Gel acts in the treatment of rosacea are unknown, but appear to include an anti-inflammatory effect.

Supplied: [gel 0.75%, cream 1%]

mupirocin  (Bactroban ® ) top of page icon

Dosing: Impetigo/infected wounds: apply three times daily.
Supplied: [ cream/oint 2%].

Nasal MRSA eradication: (bactroban nasal): 1 gram divided between nostrils twice daily x 5 days.
Supplied
: [1 gram single use tube]

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INDICATIONS
Bactroban Ointment (mupirocin ointment), 2% is indicated for the topical treatment of impetigo due to: Staphylococcus aureus and Streptococcus pyogenes.

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BACTROBAN NASAL is indicated for the eradication of nasal colonization with methicillin-resistant S. aureus in adult patients and health care workers as part of a comprehensive infection control program to reduce the risk of infection among patients at high risk of methicillin-resistant S. aureus infection during institutional outbreaks of infections with this pathogen.

NOTE:
1) There are insufficient data at this time to establish that this product is safe and effective as part of an intervention program to prevent autoinfection of high-risk patients from their own nasal colonization with S. aureus.

2) There are insufficient data at this time to recommend use of BACTROBAN NASAL for general prophylaxis of any infection in any patient population.

3) Greater than 90% of subjects/patients in clinical trials had eradication of nasal colonization 2 to 4 days after therapy was completed. Approximately 30% recolonization was reported in 1 domestic study within 4 weeks after completion of therapy. These eradication rates were clinically and statistically superior to those reported in subjects/patients in the vehicle-treated arms of the adequate and well-controlled studies. Those treated with vehicle had eradication rates of 5% to 30% at 2 to 4 days post-therapy with 85% to 100% recolonization within 4 weeks.

All adequate and well-controlled trials of this product were vehicle-controlled; therefore, no data from direct, head-to-head comparisons with other products are available at this time.


DOSAGE AND ADMINISTRATION

TOPICAL OINTMENT:
A small amount of Bactroban Ointment should be applied to the affected area three times daily. The area treated may be covered with a gauze dressing if desired. Patients not showing a clinical response within 3 to 5 days should be re-evaluated.


BACTROBAN NASAL:
Adults (12 years of age and older): Approximately one-half of the ointment from the single-use tube should be applied into 1 nostril and the other half into the other nostril twice daily (morning and evening) for 5 days.

After application, the nostrils should be closed by pressing together and releasing the sides of the nose repetitively for approximately 1 minute. This will spread the ointment throughout the nares.

The single-use 1.0 gram tube will deliver a total of approximately 0.5 grams of the ointment (approximately 0.25 grams/nostril).

The tube should be discarded after usage; it should not be re-used.

The safety and effectiveness of applications of this medication for greater than 5 days have not been established. There are no human clinical or pre-clinical animal data to support the use of this product in a chronic manner or in manners other than those described in this package insert.

Until further information is known, BACTROBAN NASAL should not be applied concurrently with any other intranasal products.

HOW SUPPLIED
Bactroban Ointment (mupirocin ointment), 2% is supplied in 22 gram tubes.

BACTROBAN NASAL is supplied in 1.0-gram tubes packaged in cartons of 10.

Neosporin ® (bacitracin /neomycin /polymyxin): top of page icon

Purpose: First aid antibiotic

Active Ingredients (in each gram)
Bacitracin 400 units
Neomycin 3.5 mg
Polymyxin B 5,000 units


Uses
First aid to help prevent infection in minor:
-cuts
-scrapes
-burns

Warnings
For external use only.

Do not use
-if you are allergic to any of the ingredients
-in the eyes
-over large areas of the body

Directions
1) clean the affected area
2) apply a small amount of this product (an amount equal to the surface area of the tip of a finger) on the area 1 to 3 times daily
3) may be covered with a sterile bandage

Polysporin ®  (bacitracin/polymyxin):  top of page icon

Purpose: First aid antibiotic

Active Ingredients (in each gram)
Bacitracin 500 units
Polymyxin B 10,000 units

Uses
First aid to help prevent infection in minor:
-cuts
-scrapes
-burns

Warnings
For external use only.

Do not use
-if you are allergic to any of the ingredients
-in the eyes
-over large areas of the body

Antibiotic Ointment
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Directions
1) clean the affected area
2) apply a small amount of this product (an amount equal to the surface area of the tip of a finger) on the area 1 to 3 times daily
3) may be covered with a sterile bandage


Antibiotic powder
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Directions
1) clean the affected area
2) apply a light dusting of the powder on the area 1 to 3 times daily
3) may be covered with a sterile bandage


Supplied: [oint/aerosol/powder]

silver sulfadiazine  (Silvadene ®) top of page icon

INDICATIONS
SILVADENE Cream 1% (silver sulfadiazine) is a topical antimicrobial drug indicated as an adjunct for the prevention and treatment of wound sepsis in patients with second- and third-degree burns.

DOSAGE AND ADMINISTRATION
Prompt institution of appropriate regimens for care of the burned patient is of prime importance and includes the control of shock and pain. The burn wounds are then cleansed and debrided, and SILVADENE Cream 1% (silver sulfadiazine) is applied under sterile conditions. The burn areas should be covered with SILVADENE Cream 1% at all times. The cream should be applied once to twice daily to a thickness of approximately 1/16 inch. Whenever necessary, the cream should be reapplied to any areas from which it has been removed by patient activity. Administration may be accomplished in minimal time because dressings are not required. However, if individual patient requirements make dressings necessary, they may be used.

Reapply immediately after hydrotherapy.

Treatment with SILVADENE Cream 1% should be continued until satisfactory healing has occurred, or until the burn site is ready for grafting. The drug should not be withdrawn from the therapeutic regimen while there remains the possibility of infection except if a significant adverse reaction occurs.

HOW SUPPLIED
SILVADENE Cream 1% (silver sulfadiazine) is available in jars containing 50 g (NDC 61570-131-50), 400 g (NDC 61570-131-40), and 1000 g (NDC 61570-131-98) and tubes containing 20 g (NDC 61570-131-20) and 85 g (NDC 61570-131-85).
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Disclaimer

Listed dosages are for - Adult patients ONLY. PLEASE READ THE DISCLAIMER CAREFULLY BEFORE ACCESSING OR USING THIS SITE. BY ACCESSING OR USING THIS SITE, YOU AGREE TO BE BOUND BY THE TERMS AND CONDITIONS SET FORTH IN THE DISCLAIMER. GlobalRPH does not directly or indirectly practice medicine or provide medical services and therefore assumes no liability whatsoever of any kind for the information and data accessed through the Service or for any diagnosis or treatment made in reliance thereon.

David F. McAuley, Pharm.D., R.Ph.  GlobalRPh Inc.
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