10 over-the-counter (OTC) antibiotics you need to know

Antibiotics are of different types. They are a class of drugs that work against infections – mainly those caused by bacteria. You may be aware that no two antibiotics are the same. Each is capable of fighting specific type of microbial infections; varying from soreness of your throat to infections inside your ears; itchiness experienced on your skin to infections in your bladder. Antibiotics do have limitations in stopping or controlling other types of infections – say, those triggered by virus – commonly referred as viral infections. You need to know when to use these anti-infection drugs and also when such drugs are not to be used. Also, there are a few medical conditions (triggered by bacterial infections) for which over the counter (OTC) antibiotics may offer needful treatment. Knowledge of such OTC antibiotics can help you save a lot of hassles and can also offer quicker access to needful remedies.

Antibiotics are drugs with antimicrobial properties to fight bacterial attacks. These drugs can treat as well as prevent infections caused by bacteria. Their primary function is to stop further progression of bacterial spread. This is done by discouraging the germs’ ability to reproduce or get duplicated in large numbers. Many antibiotics come with properties to kill the microbes. Though antibiotics are used in medical sciences, antibacterial products can include disinfecting chemicals, antiseptics, antibacterial shampoos, antimicrobial soaps, etc.

The type of an antibiotic drug varies based on the defense available at the disposal of the host, site of bacterial attack as well as pharmaceutical properties (including kinetic capabilities) of the drug. You need to remember that before the discovery of antibiotics, people had even died of common ailments say, a sore throat. Surgeries too were a lot risky then because open wounds do invite more infections. It all might seem trivial now, but there were times when people had to take each bacterial attack as a near-fatal or a fatal medical condition. Discovery of antibiotics hence is a shot in the arm for medical sciences. As a result, people are now being cured from erstwhile-fatal infections, and surgeries are being performed with enhanced safety standards.

What kind of infections can antibiotics treat?

Our body is home to many bacteria and the good news is – most of them do not harm us. Yet it is possible for you to be attacked by a few strands of bacteria. It is in such conditions can antibiotics make a big difference. The common types of infections for which antibiotics are administered include pneumonia (caused by bacteria), throat infections, kidney or bladder infections, sinus and ear infections. A few relatively common conditions include infections of teeth and skin, inflammation of spinal cord and brain (clinically termed as meningitis).

You need to know there are many infections that are caused by other germs – such as virus and foreign bodies that are not bacteria. The most common infections caused by virus are flu, cold, bronchial problems, flu in stomach etc. Antibiotics pose serious limitations if administered to such conditions. In sum, infections triggered by bacterial attacks alone are treated through antibiotics.

The catch however is, it is not easy to know the root cause of an infection; which means it can be due to bacteria, virus or any other allergic agents. Hence, your treating physician may advise you to undertake a few tests to confirm the cause of an infection. In some instances, a proper diagnosis is needed to draw out a fitting treatment plan.

Based on the efficacy levels, antibiotics may be categorized as either narrow or broad spectrum drugs. When the spectrum is narrow, such antibiotics can work only against a specific set of bacteria. On the other hand, if the spectrum is broad, such antibacterial drugs can work against various types of bacteria.

OTC antibiotics

Over the counter (OTC) antibiotics – for oral intake – are not approved for sales in US. So, the choice of OTC antibiotics in US is at a minimum. However, a few antibiotics are approved and can be purchased as OTC products. In general, OTC drugs are very helpful to those who are not covered by a medical insurance plan as well as those who wish to save on costs. In the sections below, select OTC antibiotics are listed with greater details about each.

#1. Benzoyl peroxide –

This substance is known for its antibacterial capabilities. This drug is used for treating spots on skin, acne and other skin conditions. Main function of this drug is to reduce the count of bacteria that causes acne; this chemical can successfully decrease the severity as well as the number of lesions acne triggers on your skin. Acne is formed when your sebum and keratin production is increased due to a hormonal imbalance. The drug can help decrease the quantum of sebum as well as flush away dead cells from your skin. This drug is also used in the treatment of cysts formed as part of skin infections. These cysts show up as hard bumps beneath the top layer of your skin. Though pus formation may be observed deep within, the cysts may not show up outside. This peroxide – along with a few other medications (i.e., drugs belonging to the prescribed category) – can cure such skin conditions.

You should not use this product if you have an extremely sensitive skin or if you have any known allergies to benzoyl peroxide. It is not known to develop resistance to antibiotics among people who use it. The drug is often combined with other agents such as salicylic acid or clindamycin to enhance its potential. In general, this peroxide is used to treat milder spells of acne.

It is not recommended to use this ointment to your lips, nose, eyes, etc. Also, you are not advised to apply this ointment on abrasions, cuts and sunburned areas, if any. Benzoyl peroxide based ointments are applied only for external uses. You need to wash your arms before as well as after using this drug. Of course, the areas where you have applied this ointment are not to be washed soon after use. Patients who used this drug reported a week to 10 days for improvements to show up.

Likely side effects of creams or ointments based on benzoyl peroxide are drying of skin, irritation, burning sensation, appearance of red rashes on skin, etc. If you are allergic to the drug, you may develop symptoms such as drowsiness, respiratory problems, inflammation of face, etc.

This drug may interact with dapsone – which is used for the treatment of pimples. Interactions may occur if this drug is applied with other medications. You are advised to stay aware of likely drug interactions before applying the ointment. It is a good practice to share information on pre-existing medical conditions and also about your family’s history of disorders, if any.

Benzoyl peroxide has made it to the World Health Organization’s (WHO) list of essential medications. For treating acne, it is used in concentrations of 2.5% to 10%. The concentration that suits best to you may depend on the nature of your skin. The drug is not known to have a greater efficacy if concentrations stronger than 10% are used. For a few people, high concentration of this peroxide (even upto 10%) do not cause any apparent allergies; while for others, a very diluted version of this chemical may cause allergic reactions. In general, it is better to opt for relatively high concentration levels for less sensitive areas – such as your chest or limbs. But, for very sensitive part – like your forehead or cheeks, a milder concentration (2.5% or marginally more) may be opted. In general, if your skin is not so sensitive and is also oily, then benzoyl peroxide suits well for such skin.

Dentists use this substance for whitening your teeth. Unused portions need to be disposed safely after knowing the right methods from your pharmacist. It is not a good practice to flush it in toilet or into drains.

#2. Isopropyl alcohol

This is a topical antibiotic medication used for treating bacterial infections. It is mainly used to prevent infections arising out of cuts and scrapes. It is also applied to control infections from punctures made by medical needles, especially in hospitals and healthcare facilities. It is the most common item found in first-aid cabinets in most homes. It is also used as a swab prior to injections in clinical settings.

Though the name bears the term “alcohol” in it, this drug is not for ingestion. It is used only for external application purposes. Also, it is not applied onto deep cuts, open wounds or burned skin.

The drug can cause a cold sensation wherever it is topically applied. It is also known to cause a sharp and biting sensation; at times, it can give rise to a burning feeling on the skin.

Pads used for disinfecting purposes are made with 65% to 70% of this alcohol added to water. These products have water in them which open up the bacterial pores (by attacking their membranes) and thus leave the door open for alcohol to enter in. Hand sanitizing solutions are known to contain 70% – 75% of this alcohol. At such concentrations, the substance gets into bacteria’s cell linings. Once it gains entry, it destabilizes the proteins needed for bacterial multiplication and growth. It is needless to state that once bacterial DNA is degenerated, the process brings a complete ruination of the invading germ. This chemical is also used to treat infections in the ears (such as inflammation or swelling along with pain).

Ear pain or inflammation inside your ears may be a common condition if you are a frequent swimmer. You may suffer from pains inside your ears when water gets inside the canal and other interior parts of the ear. Also, when water settles deeper into your ears, it sets the right ambience for pathogens – such as bacteria – to grow and spread. This alcohol is considered as an able companion for swimmers. It can evaporate water inside your ears into gaseous form in a short span of time. A few drops of this alcohol can prevent serious ear infections; however, these drops need to be poured inside your ears as soon as you complete your swimming session. Not only enabling locked water to get away, this drug can also completely dry the inner part of your ears; this action helps in preventing risks of likely ear infections.

You need to know that the addition of water to this alcohol closes all possibilities for the regeneration of bacteria. The main cause is addition of water slows down the rate at which this alcohol evaporates. The extended time period gives the alcohol ample time to disintegrate bacteria’s cell-level activities.

You also need to know the optimal concentration levels of this alcohol. At 90% concentration and beyond, the evaporation rate may be very fast. At a faster rate of evaporation, the time window available for contact with microbes is not sufficient for needful cell damage. At high concentration level, bacterial activity takes a dormant stand; it is far from what is needed to terminate or completely decimate foreign germs. Also, a weak concentrate of 50% is too very feeble to make any impact on bacterial infections. It is for such reasons the optimal concentration level stands at 70%.

This alcohol may also present a few risks. The most common risks or hazards are – concentrated versions can render dryness to your skin and may also cause red colored rashes to show up; if the alcohol gets into the eyes, it may prove to be very harmful to your eyesight; continuous inhalation of fumes of this alcohol can cause nausea and drowsiness. You are hence advised to wear face masks for prolonged exposure to this alcohol.

#3. Hydrogen peroxide

This is also a topical medicine with antiseptic properties, known to work against gram positive bacteria. It is used in the treatment of scrapes, burns or cuts (minor ones). This chemical works as a mouth wash to offer relief from gingivitis (bacteria in plaque that make your gums to bleed) as well as other minor conditions such as cold sores or canker.

Hydrogen peroxide is known for its ability to release oxygen upon applied onto a burn or a cut. It leads to formation of foam and in the process the damaged skin area gets cleaned of infections. This medication is not to be used in acute conditions such as serious burns, deeper wounds, injuries caused by animal bites, etc.

This chemical is not to be applied onto your eyes. This also cannot be used if you have allergies or hypersensitivity to this chemical. If you are pregnant or are nursing a baby, you need to inform about it to your treating doctor. But, in general – this product is considered safe for use by pregnant women. However, if you are a lactating mother, the use of this substance needs to be approved by a qualified medical practitioner.

In general, this topical medicine is devoid of major side effects. However, you may experience allergies such as itchiness, irritation of skin and formation of red colored rashes. If you are observing serious effects such as a swollen face or respiratory problems as well as drowsiness, you may need to discontinue the drug and consult your doctor immediately for needful advice. It is used not more than two or three times each day. It is recommended to cover the infected part with a bandage, soon after applying this medicine. Regular application of this drug is needed to get the desired relief from skin infections.

This drug is also found in the first-aid medical kits. Milder concentrates (around 3%) can be bought from your local drugstore. Milder versions are generally considered safe and are sold at an affordable price. Always remember that this drug is not to be ingested; though people use it as a mouth wash. While rinsing, never let it remain for more than 45 seconds inside your mouth. Ensure that infected areas of your mouth get an adequate exposure to this drug. It is recommended to wash your mouth and swish at least 3 times every day.

As mentioned, never consume this medicine – as it is strictly used for external uses only. For better results, you are advised to use this he drug at the same time every day. Regular use of this product is found to have fetched better results. But, if continued use of this product – for say, more than 6 days – is yielding no tangible benefits, you need to consult your treating doctor immediately. If you already have any known hypersensitivities or allergies to this medicine, talk to your pharmacist about such pre-existing conditions.

This drug may interact with the medicines that you are already consuming. Hence, it is recommended to keep your pharmacist informed about drugs you currently consume or use. It is also advised to tell your dietician about the foods you regularly take. Your dietician may advise you with foods that are to be avoided, if any – while using this medication.

#4. Iodine

Iodine is known for its antiseptic as well as antibiotic properties apart from its ability to work against a few types of virus, fungus and molds. It is found to be effective in working against microbes such as amoeba. Iodine is also found to work on select strains of bacteria – both gram-positive and gram-negative strands of bacteria. Its chemical action involves breaking of the cell structure and linings or cell walls of bacteria; thus, it can cause severe damages to invading microbes.

Medical studies attribute iodine’s efficiency levels to multiple actions such as #(1) ability to destabilize microbial cell membranes, #(2) inhibition of the protein structure of bacteria and #(3) rendering the DNA of bacteria to become defunct; thus stopping further growth or multiplication of the microbe.

Iodine is known for a very broad spectrum of action against microorganisms. It is used in a variety of medical conditions – few of them are (a) prevention of soreness of throat as well as inflammation inside your mouth, (b) treatment of infections in your gums (a condition called periodontitis wherein it is used to decrease the intensity of infections), (c) avoiding infections during and after surgical interventions, etc.

Side effects associated with the topical application of iodine include itchiness, formation of crusts on skin, etc. However, these are generally considered as not so frequently occurring side effects. While applying onto the skin, iodine is often diluted to minimize harsher side effects. It is hence considered not safe to use it on your skin without diluting the drug. Also, you are not advised to conceal the infected parts with a bandage. Such practices can lead to irritation of skin, discoloration and may also trigger a few allergies. It is also not safe to apply iodine for a few skin conditions (for instance, a few types of dermatitis called as herpetiformis). If iodine comes in contact with your eyes, you are advised to wash them thoroughly. Accidental contact with your eyes can cause irritation and other adverse side effects in your eyes.

This drug is stored in ambient temperature. It is recommended to keep it away from direct exposure to harsh sunlight, excessive heat or humidity. It is not advised to store in freezers, at very cold temperatures. Always remember to discard drugs that have reached expiry dates; make it a point to resort to safe disposal measures while getting rid of outdated drugs.

#5. Saline

This solution can wash away bacteria and other foreign germs. In effect, saline solution reduces the odds of a microbial infection. It is used for cleaning open wounds as well as minor cuts. It is also used for nasal cleaning purposes. Saline can clean mucus, bacteria and other allergens from your nasal passages; all these usages make it as a remedy for sinusitis and other infections in your sinus. Other benefits of saline solution are (1) relief from soreness of throat, (2) serves as a moisturizer for your nose to get rid of germs (you may consider adding a pinch of baking soda when you are using it to treat infections in your sinus), (3) a proven irrigator of wound, especially to get rid of debris, etc.

In general, salt is considered to have antibacterial properties. It is the reason why in most homes, salt is used as a preservative to season foods in order to make them last longer. Saline can be procured with ease from your local drug store. It can also be easily prepared at home. However, a few precautions are needed while handling saline solution. Always ensure to wash hands prior and after each use; never ingest the solution and never take it closer to your eyes.

If you sense a burning sensation or a stinging effect upon using saline solution, it means that the solution has an excessive amount of salt content in it. Always ensure to use only solutions that do not burn or sting. It is advised not to apply hot saline; a hot liquid can damage the tender parts of the wound or your nasal pathways. There are no apparent side effects triggered by saline solution. It is very rare for it to develop adverse effects, unless you have used a hot solution or a solution with a concentrated presence of salt in it. Always remember to store saline liquid in cleaner bottles for it to last longer.

#6. Neosporin

This antibiotic ointment is applied for the treatment of skin infections. This is applied onto the affected area, caused by wounds, burns, bites, cuts, etc. It mainly works against the growth and spread of bacteria. However, it has serious limitations in fighting infections caused by virus, fungi or other microbes. Its main ingredients are polymyxin B, neomycin and bacitracin.

Of these ingredients, neomycin fights against both gram negative and gram positive bacteria. Neomycin belongs to a class of chemicals called as aminoglycosides. This class of drugs can suppress the ability of bacteria to make proteins. Such control on their protein-making capabilities helps in leading to cell damages and eventually kills the microbe. The first impact of poor supply of proteins shows up in the cell membranes of bacteria. Once the walls of bacterial cells are damaged, the microbe soon dies and thus a potential spread of the infection is averted.

The other active chemical, polymyxin B attacks the walls of bacterial cells. Once their walls become porous, internal constituents of the cell begin to come out, which leads to death of the microbe.

The third major ingredient is bacitracin; this works specifically on gram positive bacteria. This chemical also works on the walls of the cell by disrupting the microbe’s membrane forming processes.

It is an external-use only medicine, and is not made for ingestion. If you have accidentally had it to come in contact with eyes or nose, you need to wash with water immediately. You are also advised to wash your hands prior to handling it, and also after each use. This medication is not to be used for more than 6 days. If outcomes are not positive, you may need to seek medical help immediately.

The ointment is applied after cleaning the infected area. A very slim layer is applied on the body part. You may need to use it twice or thrice every day. Never wear tight pants or fitting diapers after applying the ointment. Women who are nursing a baby need to consult with their treating physicians about using this antibacterial product. Medical studies indicate that it is not advisable for use by pregnant women.

This antibiotic is known to interact with a few other antibiotics (especially of the aminoglycoside genre) such as tobramycin, gentamycin, etc. It is hence recommended to tell your doctor about all the medicines you are currently taking before using this drug. This drug is not known to trigger adverse side effects. But, if symptoms such as rashes, itchiness, swelling, etc. are observed, you need to seek medical attention without much delay. If you are allergic to bacitracin, neomycin, etc. you need to keep away from this drug.

An overdose of this medicine may lead to symptoms such as sudden changes in the quantum of urine, respiratory troubles, problems with hearing, passing out, etc. If you suspect a possible overdose, you need to contact a poison control facility near your home. If you are living in Canada, you may need to reach to you a poison control center in your province.

#7. Polysporin

This is a topical medicine used for the treatment of minor infections on your skin. It is also used for treating cuts and scrapes. This drug’s key function is to slowdown as well as control the multiplication of bacteria. It is applied at least twice every day till positive outcomes show up. After applying the ointment or powder (it is also made in this form), you need to conceal the damaged area with a piece of cloth as a protective bandage.

Some people may develop side effects such as red patches on skin, irritation and a burning sensation. Most of these signs are not common occurrences. You may need to inform your treating doctor upon experiencing these symptoms. Talk to your pharmacist or doctor if you have folliculitis (blocks showing up as tiny bumps at the follicles of your hair), fungal or yeast infections and rashes on skin. The above signs do not make an entire list of likely adverse effects. Upon sensing any of these signs or any other symptoms, you need to talk to the treating doctor soon.

Neomycin – present in Neosporin – can cause a few allergic side effects; for instance, neomycin may cause dermatitis or similar such effects on few people. Polysporin does not contain neomycin in it. Instead, it is made only of two active ingredients namely polymyxin B and bacitracin. It is relatively easy to use Polysporin as the side effects are lesser than many other topical OTC antibiotics such as, say Neosporin.

This antibiotic may interact with a few other drugs. Such interactions may occur if this drug is used with other medications. Tell your pharmacist about the other medications you currently take. Keep your pharmacist informed about health supplements you may be using – such as minerals, vitamins, non-prescription medications, other OTC drugs, etc. Also, share information about habits such as intake of drinks with caffeine, alcohol, smoking habits, and if you take any restricted drugs.

This medicine may also interact with skin care drugs such as antiseptics as well as a few steroids (such as corticosteroids). If you have prior skin conditions like sores, chickenpox, shingles, eczema, etc. you need to share all such information with your pharmacist. Similarly, if you are planning to opt for a dental procedure, a surgical intervention or if you are nursing a baby, you need to inform the care provider that you are using this drug.

#8. Bacitracin

This is a medicine categorized under antibiotics. It kills bacteria and prevents infections from spreading further. It is mainly applied onto cuts or burns. It is effective against bacterial attacks, and is not efficient against fungal or viral infections. It is a medicine used only for external application purposes. A sterile cloth or bandage to conceal the wound is used for arresting the infection more efficiently. In general, this ointment never triggers any major side effects. However, if you are experiencing any allergies or discoloration of skin, you need to inform your pharmacist or the treating doctor.
This drug intervenes with lipids that enable bacteria to form cell walls and inner membrane. It is an antibiotic with a relatively narrow spectrum. It is known to be more effective against bacteria belonging to the classes called Streptococcus and Staphylococcus. Its spectrum is effective against Staphylococcus epidermidis, Streptococcus pyogenes and Staphylococcus aureus.

This drug may render some toxicity to your kidneys. Hence, the use of this drug is limited to a greater extent. Also, people who use it may need to have its presence in their blood monitored. Its common use is during post-procedure care offered soon after circumcision or other minor surgical procedures. This drug is preferred when compared to combinative antibiotics (with multiple ingredients – for example, Neosporin is a combination of bacitracin, neomycin and polymyxin B). It is for the same reason people who have known hypersensitivity or allergies to neomycin and polymyxin B are advised to use this drug.

#9. Generic version of triple antibiotic

This is a generic antibiotic drug used for infections. It is used for minor conditions triggered by infections. It is often stored as part of first-aid kits. This drug is available both as a spray and as an ointment. You may however need to consult your physician if you are using it for the treatment of serious wounds, deep burns or cuts. The drug blocks the growth of bacteria and controls infections. Usage of this antibiotic ointment on an uninfected area can impair this drug’s efficacy levels.

If you are using this product for more than 8 days (without positive outcomes), it is clear sign that you may need to seek care from a physician without further delay. Ensure not to wear tight clothing or diapers after applying this antibiotic ointment. Take needful care to tell your doctor if you are allergic to bacitracin or neomycin. If you have hypersensitivity to polymyxin B, bacitracin or neomycin, share this information with your pharmacist or treating doctor. If you develop symptoms such as rashes, red colored patches, inflammation of skin, you need to talk to your pharmacist. In some instances, this drug may cause itchiness as well as irritation of skin. Though not a common sign, a small number of people have reported hearing difficulties while using this drug. It is not clear if nursing mother may pass the chemicals to her newly born baby; hence, you are advised to take needful advice from a medical practitioner.

#10. Neosporin with pain relief cream

This drug is for external use only; it treats skin irritation as well as topical infections. It is mainly used for minor to moderate infections caused by bruises or cuts. Upon application, it is required to cover the wound or cut with a sterile cloth or a bandage. You may need to take needful advice from your pharmacist if you are using it on deeper wounds and larger cuts or burns. However, this drug is not to be used for more than 6 days. If accidentally ingested, you may need to contact a poison control center without any delay.

You need to inform your physician if you have hypersensitivity to pramoxine, neomycin or polymyxin. If you have any known allergies to any of the ingredients of Neosporin, this drug may need to be avoided.

In sum, antibiotics are drugs which can prevent and treat bacterial infections. Type of each antibiotic varies based on defense available at host’s disposal, site of attack and kinetic properties of each drug. Always remember that the human body is home to many types of bacteria. Many of them do not pose risks to us. But, some of these bacteria can turn harmful. Common types of bacterial infections that antibiotics are capable of fighting are kidney and bladder infections, sinusitis, bacterial pneumonia, throat infections and ear infections.

Antibiotics pose limitations if administered to medical conditions triggered by virus – such as flu, common cold, bronchial problems, flu in stomach, etc. The catch is to know the cause of infections – i.e., whether they are caused by bacteria, virus or allergens. Antibiotics can be classified as either broad-based or narrow spectrum medicines. When its spectrum is broader, the drug is effective against a wide array of bacteria. But, if their spectrum is narrow, effectiveness gets restricted to only a few strains of microbes.

Most of the over the counter (OTC) antibiotics are generally not approved in the US. Hence, the number of drugs available as OTC antibiotics is relatively less. However, there are a few antibiotics that are approved by regulatory authorities to be purchased through over the counter route. Of such OTC antibiotics, some of the common ones are iodine, saline solution, Neosporin, isopropyl alcohol, benzoyl peroxide, triple antibiotic (generic), hydrogen peroxide, etc. These drugs are generally considered as safe and have passed needful tests. Most of them may not trigger very adverse side effects. However, if you develop serious side effects or if your medical condition persists for long, you are advised to consult your pharmacist or doctor.

For breastfeeding mothers, some of them may face risks of chemicals being passed to their new born baby. It is hence a good practice for nursing mothers to talk to their treating doctors before using any of these OTC antibiotics.