Terramycin: Broad-Spectrum Antibiotic Ointment for Ocular and Topical Infections
Terramycin
| Product dosage: 250mg | |||
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Synonyms | |||
Terramycin (oxytetracycline with polymyxin B) is a time-tested, prescription-only antibiotic ointment formulated for the treatment of superficial ocular infections and certain topical skin infections caused by susceptible organisms. Its dual-antibiotic composition provides a synergistic bactericidal and bacteriostatic action, targeting a wide range of Gram-positive and Gram-negative bacteria. This combination helps overcome bacterial resistance mechanisms, making it a reliable choice for clinicians in both ophthalmology and dermatology. Proper diagnosis by a healthcare professional is essential before initiation of therapy to ensure appropriate use and optimal therapeutic outcomes.
Features
- Contains two potent antibiotics: oxytetracycline hydrochloride (5 mg/g) and polymyxin B sulfate (10,000 units/g)
- Available in a sterile ophthalmic ointment formulation (3.5 g tube)
- White to off-white, homogeneous petroleum-based ointment
- Bacteriostatic (oxytetracycline) and bactericidal (polymyxin B) mechanism of action
- Effective against a broad spectrum of pathogens, including Staphylococcus aureus, Streptococcus pneumoniae, Haemophilus influenzae, Escherichia coli, and Pseudomonas aeruginosa
- Preservative-free formulation reduces risk of ocular surface toxicity
- Stable at room temperature; does not require refrigeration
Benefits
- Provides comprehensive coverage against common ocular pathogens, reducing the need for combination therapies
- The ointment base prolongs contact time with ocular tissues, enabling sustained drug release and less frequent application
- Minimizes risk of emerging resistance through dual-mechanism antibiotic action
- Facilitates rapid resolution of bacterial conjunctivitis symptoms, including redness, discharge, and discomfort
- Suitable for use in both adults and pediatric populations (under medical supervision)
- Prevents secondary bacterial infections in cases of corneal abrasion or viral conjunctivitis
Common use
Terramycin ophthalmic ointment is primarily indicated for the treatment of superficial ocular infections such as bacterial conjunctivitis, blepharitis, and blepharoconjunctivitis. It is also used prophylactically to prevent infection following corneal abrasions, minor ocular injuries, or ophthalmic surgery. In dermatology, it may be applied topically for secondary infected dermatoses, impetigo, or infected wounds, though this is off-label and should be guided by culture results and clinical judgment. Its efficacy extends to infections caused by organisms susceptible to tetracyclines and polymyxins.
Dosage and direction
For ocular use: Apply a half-inch (approximately 1.25 cm) ribbon of ointment into the affected eye(s) every 3 to 4 hours, or as directed by a physician. In severe infections, more frequent application may be warranted initially. Gently pull down the lower eyelid to create a pouch, apply the ointment, and close the eye for 1–2 minutes to spread the medication. Blurred vision may occur temporarily after application. Avoid touching the tube tip to any surface, including the eye, to prevent contamination. Continue use for the full prescribed duration, even if symptoms improve earlier.
For topical skin use (off-label): Apply a thin layer to the affected area 2–4 times daily. Cover with a sterile dressing if indicated. Use should be limited to 7–10 days unless otherwise advised.
Precautions
- For external use only. Not for injection or oral ingestion.
- Do not use in the eyes if wearing contact lenses; remove lenses prior to application and wait at least 15 minutes before reinsertion.
- Discontinue use and consult a physician if rash, irritation, or hypersensitivity develops.
- Prolonged use may result in overgrowth of non-susceptible organisms, including fungi.
- Use with caution in patients with a history of allergic reactions to tetracycline or polymyxin antibiotics.
- Not recommended for deep wounds, serious burns, or extensive areas of skin breakdown.
Contraindications
- Hypersensitivity to oxytetracycline, polymyxin B, or any component of the formulation.
- Viral, fungal, or mycobacterial ocular infections where antibacterial agents are ineffective.
- Use in children under 8 years of age for systemic tetracycline is contraindicated due to risk of tooth discoloration; however, topical ophthalmic use is generally considered safe under medical supervision.
- Pregnancy and breastfeeding: Tetracyclines are contraindicated in pregnancy due to risk of fetal harm; topical use should be avoided unless potential benefit justifies potential risk.
Possible side effect
Common side effects include transient blurred vision, mild stinging or burning upon application, and eye irritation. Less frequently, hypersensitivity reactions such as itching, swelling, redness, or dermatitis may occur. Rarely, overgrowth of non-susceptible organisms (e.g., Candida) may present as worsening symptoms. Systemic absorption is minimal with topical use, but in rare cases of prolonged application to large skin areas, tetracycline-related effects such as photosensitivity or gastrointestinal upset could theoretically occur.
Drug interaction
- No well-documented clinically significant interactions with other ophthalmic medications.
- Concurrent use with other topical products may alter absorption or cause physical incompatibility; allow at least 5–10 minutes between applications.
- Oral tetracyclines can interact with antacids, iron preparations, and oral contraceptives, but these are not relevant for topical use.
- Avoid concomitant use with bacteriostatic antibiotics that may antagonize polymyxin B’s bactericidal activity.
Missed dose
Apply the missed dose as soon as remembered, unless it is almost time for the next scheduled dose. Do not double the dose to make up for a missed one. Resume the regular dosing schedule. Consistent application is important to maintain effective antibiotic concentration at the site of infection.
Overdose
Topical overdose is unlikely due to minimal systemic absorption. Accidental oral ingestion may lead to symptoms such as nausea, vomiting, and diarrhea. In case of accidental ingestion, seek medical attention promptly. Ocular overdose may cause increased irritation or blurred vision; rinse eye thoroughly with sterile saline or water if discomfort occurs.
Storage
Store at controlled room temperature (15–30°C or 59–86°F). Do not freeze. Keep the tube tightly closed when not in use. Protect from light and moisture. Keep out of reach of children and pets. Discard any unused medication after the treatment course is completed; do not save for future use.
Disclaimer
This information is intended for educational purposes only and does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before using any medication. Do not disregard or delay seeking medical advice based on information provided here. The uses described may not be approved in all regions; follow local prescribing guidelines.
Reviews
Terramycin is highly regarded in clinical practice for its efficacy, safety profile, and reliability in treating bacterial conjunctivitis. Ophthalmologists often note its broad-spectrum coverage and ease of use, particularly in pediatric and geriatric populations. Some users report mild transient blurring upon application, but overall satisfaction is high due to rapid symptom resolution. Dermatologists occasionally use it off-label for superficial skin infections with positive outcomes, though culture-guided therapy is emphasized. Long-term use is discouraged due to potential resistance.