Antibiotics - Topical: Nursing pharmacology

Definitions & Key takeaways

Topical antibiotics are a type of local antibiotics that are applied directly to the skin or mucous membranes to treat bacterial infections. They are usually in the form of creams, ointments, gels, sprays, or solutions. They work by killing or inhibiting the growth of bacteria on the skin's surface. Common topical antibiotics include mupirocin, neomycin, bacitracin, polymyxin B, mafenide acetate, and silver sulfadiazine.

Topical antibiotics are used to treat a variety of skin infections caused by bacteria, such as impetigo, folliculitis, and cellulitis. They are also used for prophylaxis of surgical site infections and for preventing the spread of infections in wounds and burns. While topical antibiotics are generally considered safe, they can sometimes cause skin irritation, allergic reactions, or antibiotic resistance if misused.

Chapters:

Watch video only

Introduction0:00–0:16

Topical antibiotics are medications used to prevent or treat infections in damaged skin, including burns, wounds, cuts, or scrapes, as well as surgical incisions.

Mechanism of action0:16–0:38

Some of the most commonly used topical antibiotics include bacitracin-polymyxin B, as well as mafenide acetate, and silver sulfadiazine.
These are non-prescription antibiotics that are applied locally in the form of an ointment. Once applied, they prevent infections by interfering with bacterial growth and proliferation.
In terms of side effects, topical use of bacitracin-polymyxin B usually doesn’t cause any adverse reactions, but some clients may present with mild skin irritation or urticaria.

Side effects0:38–1:48

On the other hand, mafenide can cause mild skin irritation and a burning sensation. Less frequent but more severe side effects include hypersensitivity reactions leading to urticaria, as well as swelling of the face, lips, tongue, or throat.
Mafenide can also cause metabolic acidosis, and some clients with G6PD deficiency have developed fatal hemolytic anemia with disseminated intravascular coagulation.Lastly, silver sulfadiazine can leave a temporary black discoloration skin, and can cause a burning sensation, a skin rash like erythema multiforme, or even skin necrosis.
Finally, systemic absorption of silver sulfadiazine has also been associated with severe hypersensitivity reactions, such as Stevens-Johnson syndrome and toxic epidermal necrolysis, as well as leukopenia, and interstitial nephritis.Topical antibiotics should be used with caution during pregnancy and breastfeeding, as well as in clients with a history of other skin conditions, such as eczema, and viral skin infections like herpes, varicella, or shingles.

Contraindications and cautions1:48–2:18

In addition, prolonged use of topical antibiotics is not recommended, since it can result in bacterial or fungal superinfection.
Finally, mafenide should also be used with caution in clients with G6PD deficiency, as well as pulmonary or renal disease.Okay, when your client is prescribed a topical antibiotic to prevent or treat infection of a skin wound, first assess the affected area, making note of the presence of any drainage, odor, redness, warmth, swelling, or pain.

Nursing considerations & client education2:18–3:55

Lastly, if your client’s surgical site incision is sutured or stapled, be sure to confirm that the edges of the incision are approximated.Now, if you are caring for a client with a surgical site incision, let them know that their medication can help to prevent or treat local infection.
When teaching about care of their incision site at home, remind them to avoid immersing the wound in water until it has completely healed; instead, instruct them to cleanse the area with mild soap and water, and to gently pat the area dry.
Remind them to always wash their hands before and after application of the topical antibiotic. Then, show them how to apply the medication to the affected area, and then cover it with a sterile dressing.
Stress the importance of applying their medication to the affected area only, and to avoid mucous membranes like the eyes and nose.
Let them know they might experience some mild skin irritation or itching; also, prompt them to notify their healthcare provider if these side effects increase, or if the incisional site becomes red, swollen, warm, if it produces a purulent discharge, if bleeding increases, or if the edges of the wound begin to separate.
Finally, monitor your client for any side effects they may experience, as well as the therapeutic effects of the medication, including resolution of the skin infection.Alright, as a quick recap … Topical antibiotics are medications used to prevent or treat infections in damaged skin, including burns, wounds, cuts, scrapes, and surgical incision.

Review3:55–4:37

These medications include bacitracin-polymyxin B, as well as mafenide acetate, and silver sulfadiazine. Some clients may develop side effects like mild skin irritation or urticaria.
Nursing considerations include performing an assessment of the affected skin area, as well as monitoring for side effects and therapeutic effects of the medication.
Finally, client teaching is focused on correct application of the medication topically, as well as side effects they may experience, and when to notify their healthcare provider.
Antibiotics - Topical: Video, Uses, and Mechanism | Osmosis