Antibiotic creams are helpful when you are suffering from Infections. You should know the best OTC medicine that helps you eliminate infections.
We will review over the counter antibiotic creams in the UK. Some over the counter creams, gels, and ointments available in the UK have 'antibiotic' properties; however, most of them are not genuinely classified as antibiotics due to their limitations in eliminating infections. The main focus of this post is to review the use and the effectiveness of 'antibiotic' creams, supported by any existing evidence. Here are include different formulations, not only creams, as this broadens your choice and discussion.
Except for chloramphenicol eye ointment for conjunctivitis, antibiotic creams cannot be purchased over the counter in the UK Antibiotic creams are prescription-only medicines. A doctor or another qualified prescribed needs to issue NHS or private prescription for supply to happen.
Online pharmacies offer a private service allowing customers to buy a prescription-only antibiotic cream. Patients are usually required to complete an online assessment, which is reviewed by a doctor who issues the prescription with the product delivered to the patient. A consultation fee is generally included in the price of antibiotic cream; however, this may vary between pharmacies.
Antiseptic creams are preparations which are applied to the skin to reduce the possibility of infections or to slow the growth of bacteria. Antiseptic creams are not absorbed into the skin a lot.
Antiseptic creams have bacteriostatic properties (stop bacteria from multiplying) as opposed to antibiotic creams, which are bactericidal (kill the bacteria).
Antibiotic creams are absorbed into the body to kill off the bacteria and prevent a bacterial infection from spreading (Nankervis H, Thomas KS, Delamere FM, et al., 2016).
In reality, however, there is no clear cut between both types of drugs. Some antiseptic/bacteriostatic products can kill bacteria, but not in sufficient amounts compared to antibiotics, which eliminate an infection. (Pankey & Sabath, 2004).
Most over the counter 'antibiotic' creams in the UK are, in fact, bacteriostatic and therefore differ from prescription-only antibiotic creams.
The main symptoms associated with skin infections include:
Patients should see their GP if the above symptoms are getting worse or if the infection spreads quickly. The most appropriate treatment in this situation would be prescription-only antibiotic cream or oral antibiotic.
Hydrogen peroxide is best known as a liquid preparation, which is usually used as a skin disinfectant and as a mouthwash. Hydrogen peroxide also comes in the form of a cream known as Crystacide.
Because hydrogen peroxide degrades fast and is ready when it comes into contact with air or water, it is safer than chlorine compounds.
What is hydrogen peroxide cream used for?
Crystacide cream is licensed to treat skin infections caused by a microorganism sensitive to hydrogen peroxide. Therapy with this cream is usually limited to three weeks.
Where can you buy hydrogen peroxide cream?
Hydrogen peroxide cream (brand name: Crystacide) is a pharmacy-only medication, which means it can only be purchased from registered pharmacies, including online chemists.
Crystacide cream is rarely prescribed in a community. It is unlikely for most pharmacies to stock this cream. Patients can ask a pharmacy team to order Crystacide cream on an individual basis for the same or next day delivery, as The leading pharmaceutical wholesalers stock crystalise cream in the UK.
Is hydrogen peroxide cream more effective than over the counter antibiotic cream?
Hydrogen peroxide has potent antimicrobial properties (stopping the growth of the bacteria) against various types of bacteria (McDonnellm 2014), including gram-positive and gram-negative bacteria.
In the lab test, hydrogen peroxide cream had similar effectiveness to hydrogen peroxide liquid with a longer duration of action. However, hydrogen peroxide is classified as an antiseptic rather than an antibiotic product.
Use of hydrogen peroxide cream for the treatment of infections
A doctor can prescribe hydrogen peroxide cream (Crystacide). Currently, hydrogen peroxide cream is one treatment option for localised impetigo in patients who are well, and there is no risk of complications. As the evidence shows, hydrogen peroxide 1% cream can be effective as a skin antibiotic for treating impetigo (NICE, 2020).
Brulidine is advertised as antiseptic and antibacterial cream, which is recommended for the management of different skin conditions, including nappy rash, superficial bacterial and fungal infections including scalp ringworm.
Additionally, as advertised, it may help heal cuts, grazes, and wounds.
The main active ingredient found in Brulidine cream is dibrompropamidine isethionate (0.15%).
Dibrompropamidine isethionate is an active ingredient included in a couple of products available over the counter, one of which is Brulidine cream. The other, Golden Eye Ointment, is a pharmacy-only medicine that contains dibrompropamidine.
Golden Eye Ointment is licensed to treat different eye conditions, including conjunctivitis, blepharitis (inflammation of the eyelids), and sties.
Is Brulidine the best over the counter antibiotics cream?
Little evidence exists to support the effectiveness of Brulidine as an antibiotic cream. Product information for dibrompropamidine isethionate classifies this ingredient as bacteriostatic (stops bacteria from multiplying) and antiseptic.
Dibrompropamidine isethionate is active against gram-positive bacteria (Staphylococcus) but less active against gram-negative bacteria. Staphylococcus (a type of bacteria) commonly causes skin infections.
Dibrompropamidine isethionate may also have antifungal properties.
Where to get Brulidine cream over the counter?
Pharmacies do not commonly stock Brulidine cream. Some pharmacies may sell Brulidine cream off their planogram. Some pharmacies can order Brulidine cream from leading pharmaceutical suppliers for the same or next-day delivery.
Brulidine cream can be purchased online, from many websites, including Amazon.co.uk (see link below).
Daktacort cream is mostly known as an antifungal cream, used in managing various fungal skin infections, for example, athlete's foot and sweat rash, and other conditions such as eczema (dry, irritated skin) and dermatitis (a type of eczema).
Daktacort contains two active ingredients, an antifungal drug (miconazole) and a mild steroid (hydrocortisone). The addition of steroids in the formulation helps to manage the symptoms of redness, itchiness, and inflammation.
Product license for Daktacort includes treatment of many gram-positive bacteria, including most strains of Streptococcus and Staphylococcus.
Daktacort can be used by adults and children over ten years of age with a maximum duration of 7 days of the treatment unless advised otherwise by a doctor. For more details about the restrictions on using Daktacort, read the product information leaflet.
Is Daktacort an effective antibacterial cream?
When tested in the lab (in vitro), miconazole was found effective against various gram-positive bacteria, with suggested treatment options for a skin infection caused by this group of bacteria (Nenoff et al., 2017).
Where to buy Daktacort cream from?
Dactacort cream is a pharmacy-only medication (P). P products can only be sold from pharmacies, including online chemists.
Dermol cream and lotion are used for the management of dry and itchy skin caused by eczema and dermatitis. Dermo; products are classified as antimicrobial agents (not an antibiotic).
Adding two antiseptics helps reduce the chances of skin infections, which are possible in eczema, for example, due to scratching. Dermol lotion is commonly used as a soap substitute.
Dermol lotion and cream active ingredients
The most common formulations, Dermol lotion (Dermol 500) and Dermol cream, contain the following active ingredients:
Is Dermol and effective over the counter antibiotic?
Dermol cream and lotion contain two antiseptic agents benzalkonium chloride and chlorhexidine dihydrochloride. Both benzalkonium and chlorhexidine are used in various pharmaceutical products due to their antimicrobial activities.
Both are commonly used as preservatives and antiseptics to minimise the growth of bacteria in different pharmaceutical products, for example, eye drops and ointments, throat lozenges and sprays, and antiseptic skin products.
As antiseptic (stop the growth of bacteria), benzalkonium chloride and chlorhexidine are effective against many gram-positive and gram-negative bacteria (Bednarek et al., 2020).
Where to buy Dermol range from?
Dermol range, including Dermol lotion and cream, are pharmacy-only products. Most pharmacies stock Dermol products in the dispensary and not on public display. One needs to speak to a member of a pharmacy team to purchase Dermol product (s). Many online chemists also stock Dermol products.
We decided to include chloramphenicol eye ointment in this review, although over the counter chloramphenicol is licensed for treating conjunctivitis, an eye infection. Chloramphenicol comes in the form of eye drops and eye ointment. Both products are pharmacy-only medicines and thus available only from chemists. Out of all reviewed products, chloramphenicol is the only medicine, which is classified as an antibiotic. When used in the treatment of conjunctivitis, chloramphenicol is safe, effective, and cheap (BMJ, 2006).
As with other drugs, it is possible to use medicines outside their license under a recommendation by a doctor who usually issues a prescription.
Chloramphenicol is a potent broad-spectrum antibiotic which is effective against many bacteria. With this, chloramphenicol is sometimes used outside its license when prescribed by a doctor. For example, chloramphenicol may be applied to wounds on the face after facial surgery to prevent infections (NHS Wirral, 2015).
One study investigated chloramphenicol ointment as a post-operative measure to reduce skin infection (single dose). It was found that the incidence of infections in a group of patients who used chloramphenicol was lower than in a group of patients who used unmedicated ointment. The reduction of skin infection was statistically significant but not clinically relevant (BMJ, 2009).
Another common unlicensed use of chloramphenicol eye ointment is a post-circumcision application to reduce the chances of infection. Chloramphenicol is also used to treat skin infections in cats and dogs.
Steroid creams are helpful in the management of skin conditions characterised by redness, inflammation, and itchiness, for example, eczema and dermatitis. Two steroid creams can be purchased without a prescription: hydrocortisone and clobetasone, the strongest over the counter steroid cream.
Steroid creams on their own should not be applied to infected skin (viral, bacterial, or fungal infections) unless a doctor advises. Some prescription-only antibiotics come as a combination of antibiotics and steroids, which can be used to treat skin infections when prescribed by a doctor.
The Selection of the most appropriate medication for bacterial skin infections is based on the severity of symptoms present and any local information on antibiotic resistance (if a particular antibiotic does not work). It results from microbiological results (NICE BNF, 2020).
Typical skin products used in the treatment of skin infections include:
We reviewed a number of over the counter antibiotic creams which are available in the UK. Although advertised as antibiotic creams, some products are antiseptic, with insufficient evidence to support their effectiveness as antibiotic agents.
Out of all reviewed products, hydrogen peroxide cream (Crystacide) has the best evidence to support its use as an antibiotic cream, which can be purchased over the counter. Daktacort (a combination of miconazole and hydrocortisone) is licensed to treat infections caused by gram-positive bacteria alongside other fungal infections.
The licensed use of Daktacor cream gives reassurance in terms of its effectiveness as over the counter antibacterial cream. Chloramphenicol eye ointment is a potent and effective antibiotic; however, its over the counter license limits the use for the treatment of skin infections.