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Lymphedema and Neosporin

There has recently been a flurry of comments being posted about lymphedema patients using neosporin as a topical antibiotic medicine. Indeed, one website even put out a page advising patients not to use it at all because of a possible allergy to it.

While it is a fact that apparently 20% of the population is allergic to it. In all the panic, however,I would like to offer what I feel is a more common sense approach to this.


January 18, 2010

As of this update of Jan 19, 2012, I have heard of no further problems with Neosporin. I am still not understanding what the big fuss was/is. Clinically speaking, no more people are allergic to this ointment then others.

Types of lymphedema wounds

First, we really need to differentiate between the types of wounds that we might be using Neosporin on.

There are wounds caused by accidents such a cuts, scratches, scrapes and the like.

Wounds that Drain Lymphorrhea

Those of us with lymphedema also get these open draining areas that we commonly refer to as a wound. These areas drain a fluid called lymphorrhea.

I'm not at all convinced that an antibiotic ointment is even call for with these draining areas. What is needed on these spots is a topcial that (1) protects the surrounding skin (2) heals the heal. That is why I personally use baby diaper lotion/ointment with zinc oxide. Zinc is a clinically proven agent that promotes skin health.

Also, what so many lymphers forget is that type of wound simply must have consistent and continual compression generally provided by our short-stretch bandages. If we do not wrap the leg/arm then it swells more. This additional swelling acts to pull apart the skin tissue that is trying to regrow. A lymphedema wound is only going to get worse unless this compresion is used.

Injury Wounds

The other type of wound we get is caused by an injury. This includes cuts, scratches, scrapes and punctures.

These wounds after being thoroughly cleaned generally do need a topical antibiotic ointment. It is imperative that these wounds be kept absolutely clean as any bacteria allowed to enter could develop very quickly intot a life-threatening case of cellulitis.

Most of these wounds are superficial and can easily be treated by us. If it is a serious wound, we really ought to get to the doctor too and not try to treat it ourselves.

To use Neosporin or not to use

I think the answer to that question is actually quite easy.

If you have never reacted to it, then I see no reason to stop using it. I have never reacted to using it - have used it for many many years - and will continue to do so. For me, it is totally safe.

If you know you do have an allergy then of course, just don't start using it. Simple, but basic common sense.

If you don't know, there is something you might try. Put a dab - and I mean a dab - on your skin (never on the limb with LE). If you start a reaction, then (1) wash it off immediately (2) never use it.

Neosporin is a Medicine

Remember, Neosporin is a medicine in a class called Polypeptide antibiotics and always should be respected and used as such. It has is a combination product containing Neomycin Sulfate, Bacitracin Zinc, and Polymyxin B Sulfate. For those of us who use it, we need to follow the guidelines and protocols for its use.

Neosporin Information


Neosporin OPHTHALMIC OINTMENT (neomycin and polymyxin B sulfates and bacitracin zinc ophthalmic ointment) is a sterile antimicrobial ointment for ophthalmic use. Each gram contains: neomycin sulfate equivalent to 3.5 mg neomycin base, polymyxin B sulfate equivalent to 10,000 polymyxin B units, bacitracin zinc equivalent to 400 bacitracin units, and white petrolatum, q.s.

Neomycin sulfate is the sulfate salt of neomycin B and C, which are produced by the growth of Streptomyces fradiae Waksman (Fam. Streptomycetaceae). It has a potency equivalent of not less than 600 µg of neomycin standard per mg, calculated on an anhydrous basis.

Clinical Parhmacology

A wide range of antibacterial action is provided by the overlapping spectra of neomycin, polymyxin B sulfate, and bacitracin.

Neomycin is bactericidal for many gram-positive and gram-negative organisms. It is an aminoglycoside antibiotic which inhibits protein synthesis by binding with ribosomal RNA and causing misreading of the bacterial genetic code.

Polymyxin B is bactericidal for a variety of gram-negative organisms. It increases the permeability of the bacterial cell membrane by interacting with the phospholipid components of the membrane.

Bacitracin is bactericidal for a variety of gram-positive and gram-negative organisms. It interferes with bacterial cell wall synthesis by inhibition of the regeneration of phospholipid receptors involved in peptidoglycan synthesis.

Microbiology: Neomycin sulfate, polymyxin B sulfate, and bacitracin zinc together are considered active against the following microorganisms: Staphylococcus aureus, streptococci including Streptococcus pneumoniae, Escherichia coli, Haemophilus influenzae, Klebsiella/Enterobacter species, Neisseria species, and Pseudomonas aeruginosa. The product does not provide adequate coverage against Serratia marcescens.

Neosporin Medline Plus

Why is this medication prescribed?

Neomycin, polymyxin, and bacitracin combination is used to prevent minor skin injuries such as cuts, scrapes, and burns from becoming infected. Neomycin, polymyxin, and bacitracin are in a class of medications called antibiotics. Neomycin, polymyxin, and bacitracin combination works by stopping the growth of bacteria.

How should this medicine be used?

Neomycin, polymyxin, and bacitracin combination comes as an ointment to apply to the skin. It is usually used one to three times a day. Neomycin, polymyxin, and bacitracin ointment is available without a prescription. However, your doctor may give you special directions on the proper use of this medication for your medical problem. Follow the directions on the package or those given to you by your doctor carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use neomycin, polymyxin, and bacitracin combination exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor or written on the package.

This medication is for use only on the skin. Do not let neomycin, polymyxin, and bacitracin combination get into your eyes, nose, or mouth and do not swallow it.

You may use neomycin, polymyxin, and bacitracin combination to treat minor skin injuries. However, you should not use this medication to treat deep cuts, puncture wounds, animal bites, serious burns, or any injuries that affect large areas of your body. You should call your doctor or get emergency medical help if you have these types of injuries. A different treatment may be needed. You should also stop using this medication and call your doctor if you use this medication to treat a minor skin injury and your symptoms do not go away within 1 week.

Do not apply this medication to a child's diaper area, especially if the skin surface is broken or raw, unless told to do so by a doctor. If you are told to apply it to a child's diaper area, do not use tightly fitting diapers or plastic pants.

To use the ointment, follow these steps:

Wash your hands well with soap and water. Wash the injured area with soap and water and pat dry thoroughly with a clean towel.

Apply a small amount of the ointment (an amount equal to the size of your finger tip) to the injured skin. A thin layer is all that is needed. Do not touch the tip of the tube to your skin, hands, or anything else. Replace and tighten the cap right away. You may cover the affected area with a sterile bandage. Wash your hands again.

Other uses for this medicine

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

What special precautions should I follow?

Before using neomycin, polymyxin, and bacitracin combination,

tell your doctor and pharmacist if you are allergic to neomycin (Myciguent, others); polymyxin; bacitracin (Baciguent, others); aminoglycoside antibiotics such as amikacin (Amikin), gentamicin (Garamycin), kanamycin (Kantrex), paromycin (Humatin), and tobramycin (Nebcin, Tobi); zinc; or any other medications. tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention aminoglycoside antibiotics such as amikacin (Amikin), gentamicin (Garamycin), kanamycin (Kantrex), paromycin (Humatin), and tobramycin (Nebcin, Tobi). Your doctor may need to change the doses of your medications or monitor you carefully for side effects. tell your doctor if you have or have ever had hearing problems or kidney disease. tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using neomycin, polymyxin, and bacitracin combination, call your doctor. What special dietary instructions should I follow? Return to top

Unless your doctor tells you otherwise, continue your normal diet.

What should I do if I forget a dose?

Apply the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not apply a double dose to make up for a missed one.

What side effects can this medication cause?

Neomycin, polymyxin, and bacitracin combination may cause side effects. If you experience any of the following symptoms, call your doctor immediately:

skin pain, irritation, burning, swelling, or redness itching rash hives red, scaly patches on skin difficulty breathing or swallowing swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs hoarseness chest tightness faintness dizziness Neomycin, polymyxin, and bacitracin combination may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at] or by phone [1-800-332-1088].

What storage conditions are needed for this medicine?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

In case of emergency/overdose

You should not swallow neomycin, polymyxin, and bacitracin ointment. If someone does swallow this medication, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

What other information should I know?

If your doctor has told you to use this medication, keep all appointments with your doctor. Call your doctor if you still have symptoms of infection after you finish using this medication as directed.

Ask your pharmacist any questions you have about neomycin, polymyxin, and bacitracin combination.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

Brand names

Mycitracin® Neosporin® Triple Antibiotic Ointment®

Neosporin Medline Plus

Effect of combined chlorhexidine gluconate and Neosporin on experimental keratitis with two pathogenic strains of Acanthamoeba.

Dec. 2011

Akin Polat Z, Vural A. Source Department of Medical Parasitology, Cumhuriyet University School of Medicine, 58140, Sivas, Turkey, Abstract Acanthamoeba keratitis (AK) is a painful, sight-threatening, and difficult-to-treat corneal infection caused by the ubiquitous free-living amoebae Acanthamoeba species. The aim of the present study was to compare the severity of keratitis, caused by Acanthamoeba hatchetii and Acanthamoeba castellanii infections, and to assess the therapeutic effects of combined chlorhexidine (CHX) and Neosporin® treatment in rats. The rats were first divided into two groups, in which the eyes of the animals were infected with A. hatchetii or A. castellanii trophozoites. On day 5, all corneas were examined in order to determine the degree of infection (grade 0 to 3), and animals were divided into two new groups, treatment and infected control groups. The treatment was continued for 28 days, followed by excision and histological evaluation of the corneas. In conclusion, the clinical picture progressed more rapidly and severely in eyes infected by A. castellanii, while it was non-invasive and slower to progress with A. hatchetii. Moreover, eyes infected by A. hatchetii responded quicker and more positively to therapy, consistent with its clinical course, while a longer recovery was seen with A. castellanii. Histological examinations revealed the presence of A. castellanii and A. hatchetii trophozoites in the stroma of eyes of the treatment and control groups. As a result, our findings suggest that a combination of Neosporin with lower doses of CHX may be beneficial to treat patients with early diagnosis of AK.


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lymphedema_and_neosporin.txt · Last modified: 2012/10/16 14:40 (external edit)