Triple Antibiotic Ointment Dosing
Apply a small amount (approximately the size of a fingertip) of triple antibiotic ointment to the affected area 1-3 times daily after cleaning the wound.
Standard Application Protocol
- Apply topically to clean, minor wounds 1-3 times per day until the wound is healed or as directed by a healthcare provider 1, 2.
- Use a thin layer covering the entire wound surface—excessive amounts provide no additional benefit 1.
- Cover with a clean, dry bandage after application to maintain moisture and prevent contamination 3.
Appropriate Clinical Indications
Triple antibiotic ointment (neomycin, polymyxin B, bacitracin) is indicated for:
- Minor skin trauma and superficial wounds to prevent infection 1, 2.
- Uncomplicated soft-tissue wounds after repair, where it significantly reduces infection rates (4.5-5.5%) compared to petrolatum alone (17.6%) 4.
- Secondarily infected superficial skin lesions such as small lacerations, abrasions, or minor burns 3.
Important Clinical Limitations
Triple antibiotic ointment is NOT appropriate for:
- Purulent cellulitis or abscesses—these require systemic antibiotics and/or incision and drainage 3, 5.
- Deep or complicated skin infections—systemic therapy is required 3.
- Large furuncles or carbuncles—incision and drainage is the definitive treatment, with systemic antibiotics added if fever or systemic signs are present 5.
Pediatric Considerations
- Safe for children as young as 2 months for appropriate indications 5.
- For minor skin infections like impetigo in children, mupirocin 2% topical ointment is preferred over triple antibiotic ointment 3.
- Apply the same frequency (1-3 times daily) as in adults for minor wounds 1.
Duration of Therapy
- Continue application until wound healing is complete, typically 7-10 days for most minor wounds 1.
- Discontinue if signs of allergic reaction develop (erythema, pruritus, rash), though neomycin sensitization rates are low with proper use 1, 2.
Key Clinical Pitfalls
- Do not use as monotherapy for infected wounds requiring systemic antibiotics—the ointment is for prophylaxis and very superficial infections only 3.
- Resistance remains rare despite decades of over-the-counter use, with 95-98% of common pathogens remaining susceptible 6.
- Maintains activity against mupirocin-resistant strains, making it a useful alternative when mupirocin resistance is present 6.