The Medicinal and Other Uses of Triple Antibiotic Ointment

Before getting into the uses of triple antibiotic, let’s clarify an essential point. 

While the terms Neosporin and triple antibiotic are often used interchangeably in the medical community (because the licensed professionals have a certain level of understanding in their lingo), the terms are definitely not interchangeable.  You see, Neosporin is a brand name used on many different products, some of which contain no antibiotic at all.  A quick search showed that Amazon carries the following products under the Neosporin brand name:

• Neosporin Original Ointment contains bacitracin zinc (400 units), neomycin sulfate (3.5 mg), and polymyxin B sulfate (5000 units).  It also has the much touted Heliderm technology that “provides a nourishing environment for skin to heal”) and inactive ingredients of cocoa butter, cottonseed oil, olive oil, sodium pyruvate, vitamin E oil, and white petrolatum. 
• Neosporin Plus Pain Relief contains all the above antibiotics in the same quantities, plus pramoxine HCl for pain relief. 
• Neosporin Dual Action Plus Pain Relief (a dual antibiotic) has neomycin sulfate (3.5 mg) and polymyxin B sulfate (10000 units), plus 10 mg pramoxine HCl for pain relief.  The inactive ingredients are emulsifying wax, methylparaben, mineral oil, propylene glycol, purified water, and white petrolatum.
• Neosporin Dual Action ointment + pain relief has the same active ingredients as Neosporin Dual Action Plus Pain Relief with only white petrolatum for the base.
• Neosporin Multi Action Ointment—Pain-Itch-Scar has the same active ingredients as Neosporin Plus Pain Relief.  The inactive ingredient base consists of petrolatum, cottonseed oil, olive oil, cocoa butter, tocopherol acetate, and sodium pyruvate.
• The versions marketed for children have the exact same active ingredients in the same amounts, but with cute illustrations to justify the higher price.  The inactive ingredients are emulsifying wax, methylparaben, mineral oil, propylene glycol, purified water, and white petrolatum.
• Neosporin Lip Health products don’t contain any antibiotics at all.

All that to say that you can't just pick up a Neosporin product and assume that it is a triple antibiotic.  And to reiterate that the stuff for children is often just marketing with a higher price tag for the gullible.

Bacitracin zinc, neomycin sulfate, and polymyxin B sulfate are the antibiotics.  Pramoxine HCl is a topical analgesic for pain and itch relief.  The inactive ingredients vary.  Some will make a cream; others are much closer to Vaseline in appearance and consistency.  The off brands generally use Vaseline (listed as white petrolatum in the inactive ingredients) as the base. 

There are also dual and single antibiotic ointment options that are better for people who are allergic to one of the antibiotics.  Neomycin is the most common culprit.  Unfortunately, the allergic reaction looks a lot like a local infection, so the patient applies more antibiotic ointment, which naturally makes the reaction worse. 

Triple antibiotic ointments are most often purchased in 0.5-2.0 ounce squeeze tubes.  However, triple antibiotic is also sold in small packets ideal for first aid kits. 

Triple antibiotic is used on minor cuts, abrasions, and burns to prevent infection and speed healing.  It’s also used over stitches to prevent infection at the wound site.  Basically, it is used just about whenever and wherever Vaseline is used.  But is it really necessary?

A study published in the Journal of the American Medical Association indicates that white petrolatum, also known as Vaseline or petroleum jelly, is just as effective.  Increasing concerns about antibiotic resistance may warrant using antibiotic ointments less frequently.  But in a society in upheaval where trivial infections can turn deadly, one might wish to do everything possible to increase the odds in their favor. 

Most antibiotic ointments have a stated shelf life at manufacture of about two years.  Unlike pharmaceutical tablets and capsules, testing hasn’t been conducted to ascertain whether antibiotic ointments are efficacious past that period.  So what do you do with the outdated ointments?

Remember, for most of them the base is Vaseline, which has an indefinite shelf life.  Vaseline all on its own works very well for preventing infection and hastening healing.  Beyond the medicinal uses of Vaseline that were covered in a post last month, the expired triple antibiotic ointment can be used wherever Vaseline is used:

• Lip balm
• Vaseline-gauze dressings
• Vaseline-cotton ball firestarters
• Moisturizing pet paws
• Remove gum from hair
• Stop door hinges from creaking

Links to related posts:

Medicinal Uses of Vaseline

Wound Dressings

DIY Vaseline-Gauze Dressings

Cotton ball-Vaseline Fire Starters

References:

David Phillips Smack, et al., “Infection and Allergy Incidence in Ambulatory Surgery Patients Using White Petrolatum vs Bacitracin Ointment:  A Randomized Control Trial,” JAMA, 276(12), https://jamanetwork.com/journals/jama/article-abstract/408314 (accessed 25 November 2020).

 22 december 2020