OTC Topical Antibiotics

Bacitracin: Bactericidal against Gm+. Can develop allergic contact dermatitis with prolonged use.

Polymyxin B: Bactericidal against Gm-. Often combined with bacitracin.

Neomycin: Bactericidal against Gm+ and Gm-, good S. Aureus coverage. Can develop allergic contact dermatitis with prolonged use.  Often combined with bacitracin and polymyxin B.

Prescription Topical Antibiotics

Due to potential for development of resistance, topical antibiotics should be used as part of a treatment to treat localized infections and not as component of routine maintenance of chronic skin conditions.

Mupirocin: Bactericidal against MRSA, good Gm+ coverage. Excellent choice for impetigo as well as part of decolonization protocol for MRSA.

Fusidic acid: Bacteriostatic against Gm +, especially S. Aureus.

Erythromycin: Bactericidal against most Gm+ and C. acnes. Also has a significant anti-inflammatory effect.  Used for acne and rosacea. Safe in pregnancy.

Clindamycin: Broad spectrum coverage, including anaerobic. Used for acne and rosacea. Safe in pregnancy. Bacteria readily develop resistance so must be used in combination (see above).