Guide To Over-The-Counter Antibiotics

October 14, 2023

Antibiotics are medications that treat bacterial infections. Some types of antibiotics work by killing bacteria, and others stop bacteria from growing and spreading. Doctors prescribe certain antibiotics for topical use and others for patients to take orally. In cases of serious infection, patients will receive antibiotics intravenously or through an injection. Antibiotics are not effective on viral infections. Thus, they should not be used to treat influenza, the common cold, most types of bronchitis, and similar conditions. Patients must always finish their entire course of antibiotics to avoid resistance.

Many patients want the best over-the-counter antibiotics to treat infections. Antibiotics are common as a treatment for strep throat. They are also used for the treatment of urinary tract infections and some sinus infections. Antibiotic treatment for severe ear infections may be used as well. However, although there are some good over-the-counter antibiotics, specifically topical antibiotic ointments, patients must understand why most antibiotics are prescription-only.

Why Most Antibiotics Are Prescription

In the United States, most antibiotics are only available with a prescription. This is because doctors have the expertise to determine if an antibiotic is necessary for the patient's condition. They know which antibiotics will be effective for particular health concerns. They are also able to take the patient's overall health into account when prescribing the antibiotic. Some antibiotics may not be appropriate for individuals with certain health conditions.

Suppose patients could purchase most antibiotics without a prescription. In that case, they may use them for viral infections and other conditions that do not respond to antibiotics, contributing to antibiotic resistance. Some antibiotics may cause serious side effects. Offering these as prescription-only medicines allows doctors and patients to discuss potential side effects and what to do if they occur. In this way, patients can understand the benefits and risks that antibiotic use may have for their overall health and make a more informed choice.

Polymyxin B

Polymyxin B is frequently used to treat infections of the urinary tract, blood, eyes, and meninges. In these cases, this antibiotic is administered by injection. Typically, it is a prescription-only antibiotic. However, polymyxin B can be mixed with bacitracin. This creates an over-the-counter antibiotic ointment that is sold under the brand Polysporin. It is intended for use on skin, and it helps treat minor skin wounds, including scrapes, cuts, and burns. The ointment may help the wounds heal more quickly as well. Some individuals also apply this ointment to their skin to treat or prevent mild infections.

Patients should clean the affected area before using Polysporin. Once the area is dry, they must apply a thin layer of the ointment and rub it carefully into their skin. Patients can safely apply this antibiotic ointment up to three times per day. If desired, they can cover the treated area with a bandage after application. However, they need to use a new bandage every time that they apply ointment. If symptoms persist or worsen after using this ointment for seven days, the patient should consult a physician.


Bacitracin can be purchased over-the-counter as a topical antibiotic ointment. As mentioned, it can be found in Polysporin, but also on its own. It is intended for the treatment of minor scrapes, cuts, and burns. This antibiotic may help prevent these minor wounds from becoming infected. Patients should not use it to treat animal bites, severe burns, or puncture wounds. Additionally, it is not safe for use on deep wounds. Individuals with allergies to mineral oil or petroleum jelly should not use bacitracin ointment.

When using bacitracin, it is essential to use it on the affected skin only and never over large areas. Bacitracin can be safely applied to the skin one to three times each day. Patients may want to cover the area with a bandage each time they reapply. Pregnant or breastfeeding women must ask their doctor before using bacitracin. Rarely, an allergic reaction to bacitracin may occur. This could produce hives and swelling of the face, lips, or tongue. Some individuals could experience breathing difficulties if an allergic reaction is severe. If the patient shows signs of an allergic reaction, they should seek out emergency medical care.


Neomycin is used in over-the-counter skin ointments. Many of these ointments also contain polymyxin B or bacitracin. As with other antibiotic ointments, this one is used to prevent infection and speed up the healing of minor cuts, scrapes, and burns. Some patients may wish to apply this type of ointment to sores as well. Patients must wash their hands before and after applying neomycin ointment. They should apply a thin layer of the ointment to the affected area. Patients can safely rub it into the treatment site. Individuals with kidney disease should check with their physician or pharmacist to ensure that neomycin is safe for them. If a large amount of this antibiotic is absorbed into the body, patients may develop kidney issues or hearing loss. Thus, patients should not apply this ointment to broken skin. In addition, they should not use it in amounts larger than what is recommended on the package instructions.

Patients who become pregnant during treatment with neomycin should inform their doctor immediately. In general, this antibiotic should not be used on a child's diaper area. If a doctor recommends this type of use, the child's diapers should not be tight, and plastic pants should not be used. This is because plastic pants and tight diapers could increase the amount of neomycin that the body absorbs, which may increase the risk of side effects. Occasionally, neomycin could cause redness, itching, burning, or irritation at the application site. Some patients may develop a rash. Patients who notice any of these effects should let their doctor know right away.


Some over-the-counter throat lozenges contain gramicidin. This antibiotic is also found in topical ointments for skin wounds. In addition, certain products combine gramicidin with tyrocidine or other antibiotics. It can be combined with antiseptics as well. Most lozenges with gramicidin also contain an anesthetic to numb the throat. Individuals who have allergies to antibiotics or anesthetics should check with a doctor before use.

Sucrose, a type of sugar, may be used as an inactive ingredient in the lozenges. Diabetes patients may need to use sugar-free lozenges. Of course, individuals with sucrose allergies should not use this medicine. Patients who take sulfonamide antibiotics or anticholinesterases may require an alternate medication as well. Although it is safe to take one lozenge as needed to relieve throat pain, patients should never take more than eight lozenges per day. Children under twelve years old should not use these lozenges.

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