First Aid - Neosporin/Polysporin

Hi everyone,

Does it make sense to pack Neosporin (Polysporin in Canada) antibacterial ointment that is ophthalmic (for the eyes) in your small kit (space is a concern, the kit must be readily available in a pocket) Can it be used everywhere on other wounds?

Thanks
François

Keep in mind that some people are allergic to the neomycin in trible antibiotic ointments (which includes Neosporin). That's bad enough on the skin, but if it happened in an eye it would be a lot worse.

Double antibiotic ointment using bacitracin is just as effective without the allergy risk, though I have no idea if it is opthalmic.

There are a couple wrinkles with the naming between Canada and the States. In the US, 'Polysporin' is a double antibiotic with bacitracin and polymyxin. In Canada, 'complete Polysporin' is a triple antibiotic with bacitracin, polymyxin, and gramicidin but no neomycin. More info here.

ETA: I have a friend who is a dermatologist. He says that if you clean a wound well and keep it covered with petroleum jelly (Vaseline), it will heal just as well as if you used an antibiotic ointment. However I need to ask him how this goes if you are in a situation where cleaning the wound thoroughly is difficult.

I tried managing a not too bad dog bite at home with betadine scrub, copious irrigation, soaks, and antibiotic ointment. It worked poorly. Too deep, too contaminated...too stupid.

If cleaning the wound is difficult, the wound might be too deep to be helped by a dab of antibiotic ointment on the top. Time to abort the mission and head back to civilization. Puncture wounds, foreign bodies, ragged wounds, crush injuries and the like may need surgical exploration and debridement, as well as oral or parenteral antibiotics.

Yes, as Glock-A-Roo said, Polysporin and Neosporin are NOT the same formulation - at least not here in the US. My wife is a Nurse Practitioner and she uses only Polysporin on patients because of the allergy/irritation potention with Neosporin (I can't remember if she said it was "allergy" or "irritation", so we'll go with Glock-A-Roo's statement that it is "allergy").

FWIW, Neosporin works fine on me - I have no problems with it. But others do.

Also, my wife said that slathering a bunch of antibiotic ointment on some wounds so that air cannot get to them will actually INCREASE the likelyhood that they will get infected despite the fact that you are slathering them with ANTIBIOTIC ointment. I guess it might depend on the specific bacteria or something. So keep that in mind when using these ointments - they can be helpful, but they are not a panacea.

So true, well said.

I have made good use of antibiotic ointment during long backpacking trips.

The first time was on a case of "barbers itch" a staff like skin
infection that started in a blister under a pack strap. The second was as eye infection from excessive horse poop dust in the trail, combined with soft contact lenses .

I was glad I had it as it took a couple of days to evacuate each
time.

I just did a quick check, and the concentration of the antibacterial ingredients appears to be equivalent between the regular and opthalmic versions. I'm not sure how well the drops will work on a wound, especially if they drain off right away. For a superficial cut or scrape, I think I would prefer an ointment that will maintain contact with the wound for a while, but in a pinch, it appears that the opthalmic version could work just as well in theory. Anyway, for what it's worth...

I believe God made Neosporin. It has been my go-to dope for everything including the dogs nose. After this read, I must now test it in all of the farmsteads eyes.

In the past we used regular neosporin to treat the matting eyes of our outside cats and it always worked. However, I don't think I would try this on people without asking a legitimate medical professional. My advice is to consult your regular family doctor.

It's not just the drug, it's the delivery agent as well. A petroleum-based delivery agent may be just fine for your skin, but not so good for your eyes. While it may not harm your eyes (I don't know this), it may be uncomfortable or not disolve well in tears and you then end up looking through a smeared haze for a while. I would recommend using medicines as they are intended to be used by the manufacturers in cases like this.

IIRC Neosporin Opthalmic Ointment is a sterile packaging of regular Neosporin. It is much more expensive than regular neosporin and (again iirc) it requires a prescription. Regular single use packets of neosporin may be more cost effective, and fit your space requirements just as well. OTOH, if you already have Neosporin opthalmic and are just wondering if it will work on regular wounds, since the formulations are the same, it should work as regular neosporin.

Edited to add: the opthalmic ointment is in a petrolatum base just like the regular ointment.

http://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?id=2262&type=display

Eye drops are less effective than eye ointments, which are petrolatum based, cuz the medicine sticks around longer. Eyes are a special kind of skin, and usually heal up remarkably well...until they don't, in which case, stubborn infection in one eye is sometimes best treated by enucleation (removal) of the infected eye, to prevent transmission to the healthy eye...Be careful when treating eyes. ER docs mostly don't treat eyes unless the problem is real simple: they call for a specialist consult early and loudly, cuz eyes are tricky, delicate, and highly regarded by their owners. I heartily endorse the final thought: use medications cautiously and as directed, watch the patient with cat-like intensity for worsening symptoms, and get skilled help sooner rather than later.

I remember back when I was a paramedic - we had an ophthalmic anesthetic we were allowed to use per protocol - Opthane (I'm not sure if that's the correct spelling of the drug). However, our standing orders were that we NOT administer it until the patient was already IN the ambulance and we were DRIVING down the road to the ER. This was because it is very effective at taking the pain away, so then the patient might say "I don't need an ambulance", walk off, and start rubbing their newly anesthetized eye and causing all kinds of problems that they wouldn't realize because they couldn't feel it.

An eye ointment for infection that worked well for me in the backcountry was mercuric oxide. I bought it over the counter and
took it in my first/second aid kit.

http://www.ncbi.nlm.nih.gov/pubmed/2344168

Oh goodness, I would never recommend using regular Neosporin in your eyes! But the OP was questioning whether the opthalmic version could be used on general wounds. I'm assuming that the OP finds the small packaging of the opthalmic version to be convenient for him and that's why he's asking.

Ah, I hadn't realized that Neosporin Opthalmic comes in both an ointment and a solution. I had only found info on the solution first when I was looking up the concentrations of the active ingredients.

Yes the situation would be a bushcraft training session where I would be at risk of getting cut injuries from a knives, tools, branches etc. I would use everything as soon as possible, cleaning, benzalkonium wipe, polysporin and telfa pad etc. I would really want to use everything to avoid sepsis (blood poisonning).

We use a lot of "colloidal silver" spray on cuts and other wounds. This often times works better than the antibiotic ointments. It worked a treat on a recent dogbite I had on my hand. We use it on our horses when they get the inevitable gashes and gouges, and also on ourselves. You can buy it for humans, but the horse stuff is the same and about half the price.

We use horse bandaging materials ("cohesive bandaging wrap") on ourselves too. Same stuff, but tons cheaper than the identical product sold in human pharmacies. Plus, the horse bandages come in lots of flashy colors, not just the drab muted tan of the human variety.

But if you want something that can double as fire paste, you need one of the antibiotic ointments with a petroleum base.