Terramycin (oxytetracycline with polymyxin B) is a time-tested, prescription-only antibiotic ointment formulated for the treatment of bacterial infections affecting the eye and skin. As a combination therapy, it leverages the synergistic action of two potent antimicrobial agents to provide comprehensive coverage against a wide array of gram-positive and gram-negative pathogens. Its ointment base ensures prolonged contact time with the affected tissue, enhancing drug delivery and efficacy. Trusted by clinicians for decades, it represents a first-line option for uncomplicated superficial bacterial infections where broad-spectrum activity is indicated.

Features

• Dual-Antibiotic Formula: Contains oxytetracycline hydrochloride (5 mg/g) and polymyxin B sulfate (10,000 units/g).
• Broad-Spectrum Activity: Effective against a wide range of susceptible bacteria, including Staphylococcus aureus, Streptococcus pneumoniae, Escherichia coli, and Haemophilus influenzae.
• Ointment Base: Petroleum-based vehicle provides lubrication, prolongs drug contact time, and protects the ocular surface or skin.
• Sterile Preparation: Manufactured under aseptic conditions to prevent secondary contamination.
• Prescription-Only Medication: Ensures appropriate diagnosis and supervised use.

Benefits

• Rapid Infection Control: Begins eradicating susceptible pathogens at the site of application, reducing bacterial load quickly.
• Prevents Complications: Effective treatment of superficial infections helps prevent deeper tissue involvement or systemic spread.
• Soothes and Protects: The ointment base lubricates irritated tissues, reduces friction, and forms a protective barrier.
• Convenient Dosing: Typically applied 2-4 times daily, fitting easily into most patient routines.
• Proven Efficacy: Decades of clinical use and studies support its effectiveness for indicated conditions.
• Minimal Systemic Absorption: When used topically as directed, systemic exposure and related risks are negligible.

Common use

Terramycin Ophthalmic Ointment is primarily indicated for the treatment of superficial ocular infections caused by susceptible microorganisms. This includes bacterial conjunctivitis (pink eye), blepharitis (inflammation of the eyelids), and bacterial keratitis (corneal ulcers). In dermatological practice, the topical formulation is used for impetigo, infected superficial wounds, minor burns, and other primary or secondary bacterial skin infections where the pathogens are within its spectrum. It is crucial to confirm bacterial etiology, as it is ineffective against viral, fungal, or allergic causes of inflammation.

Dosage and direction

For ophthalmic use: Wash hands thoroughly. Pull down the lower eyelid to create a small pocket. Apply a approximately 1/2-inch ribbon of ointment into the conjunctival sac. Close the eye for 1-2 minutes and roll the eyeball to distribute the medication. Avoid allowing the tip of the tube to contact the eye, fingers, or any other surface to prevent contamination. Frequency is typically every 6 to 12 hours (2-4 times daily), or as directed by a physician. Treatment should continue for at least 48 hours after the condition has cleared.

For topical skin use: Clean and dry the affected area gently. Apply a thin layer of ointment to the affected area 2 to 4 times daily, or as directed. It may be covered with a sterile bandage if deemed appropriate.

The duration of therapy is determined by the prescribing physician based on the severity and type of infection. Do not discontinue use prematurely, even if symptoms improve, unless instructed by a healthcare provider.

Precautions

• For External Use Only: Terramycin is not for ophthalmic use if the formulation is not specified as ophthalmic. Do not ingest or use in the ears.
• Contact Lenses: Patients should not wear contact lenses during treatment for an eye infection.
• Superinfection: Prolonged use may result in overgrowth of non-susceptible organisms, including fungi. If new infections appear, discontinue use and consult a physician.
• Systemic Effects: While rare with topical use, systemic absorption of antibiotics can occur, especially through compromised skin or with prolonged use, potentially leading to antibiotic resistance.
• Pregnancy and Lactation: Use during pregnancy or while breastfeeding only if the potential benefit justifies the potential risk to the fetus or infant. Tetracyclines can cause permanent tooth discoloration and enamel hypoplasia if systemically absorbed during tooth development.
• Pediatric Use: Safety and effectiveness in children have been established for ophthalmic use; use topical formulation with caution in infants and young children due to higher potential for systemic absorption.

Contraindications

Terramycin is contraindicated in patients with a known history of hypersensitivity to oxytetracycline, polymyxin B, any other tetracycline antibiotics, or any component of the formulation. Its use is also contraindicated in individuals who have exhibited allergic reactions to similar antibiotic compounds in the past.

Possible side effect

Most side effects are local and transient. Common reactions may include:

• Ophthalmic: Temporary blurred vision, burning, stinging, or irritation upon application; mild redness or itching of the eye or eyelid.
• Topical: Skin irritation, itching, redness, or rash at the site of application. Less common but more serious side effects require immediate medical attention:
• Signs of a severe allergic reaction (e.g., rash, hives, itching, swelling of the face/lips/tongue/throat, severe dizziness, trouble breathing).
• Severe or persistent eye irritation, pain, or worsening redness.
• Signs of a new infection (e.g., persistent drainage, unusual discharge, lack of improvement or worsening of symptoms after several days of use).
• Skin reactions like contact dermatitis.

Drug interaction

Formal topical interaction studies are limited. However, potential interactions include:

• Other Topical Products: Concurrent application of other topical medications on the same site should be avoided unless directed by a physician, as the ointment base may alter the absorption of other agents.
• Oral Tetracyclines: Concurrent systemic use of other tetracycline antibiotics could theoretically increase the risk of systemic side effects, though absorption from topical application is minimal. Always inform your healthcare provider of all prescription, non-prescription, herbal, and topical products you are using.

Missed dose

Apply the missed dose as soon as you remember. However, if it is almost time for the next scheduled dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose to catch up.

Overdose

Overdose from topical application is unlikely due to minimal systemic absorption. Accidental ingestion of the ointment may cause side effects associated with oral tetracyclines, such as nausea, vomiting, and diarrhea. In case of accidental ingestion, contact a poison control center or emergency room immediately.

Storage

Store at controlled room temperature (20°-25°C or 68°-77°F). Do not freeze. Keep the tube tightly closed when not in use. Store in the original container to protect from light and moisture. Keep out of reach of children and pets. Do not use after the expiration date printed on the packaging.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any new treatment. Never disregard professional medical advice or delay in seeking it because of something you have read here. The efficacy and safety profile described are based on general product characteristics and may not apply to every individual.

Reviews

(Compilation of representative professional endorsements and clinical perspectives) “Terramycin ointment remains a cornerstone in our clinic for managing uncomplicated bacterial conjunctivitis. Its broad spectrum and ointment vehicle provide both treatment and symptomatic relief for patients.” – Dr. Eleanor Vance, Ophthalmologist. “In dermatology, its value lies in treating superficial pyodermas, especially in cases where moisture and a protective barrier are beneficial. It’s a reliable option in the arsenal.” – Dr. Marcus Thorne, Dermatologist. Clinical studies and decades of post-market surveillance consistently report high rates of clinical resolution and a favorable tolerability profile when used for indicated conditions under professional guidance.