hydrocortisone + oxytetracycline hydrochloride: clinical use

Prescribing considerations

• Confirm inflammation with secondary bacterial infection and avoid unnecessary topical-antibiotic exposure.
• Consider organism identification and susceptibility testing in exudative dermatoses because Pseudomonas and Proteus are recognised secondary pathogens but are generally not susceptible.
• Reassess non-response because hydrocortisone may mask extension of infection.
• Avoid extended or recurrent application because of contact sensitisation and antimicrobial overgrowth.
• Large treatment areas or occlusion can increase systemic corticosteroid absorption.

Contraindications and cautions

• Hypersensitivity to any component
• Primary bacterial skin infections such as impetigo, pyoderma or furunculosis
• Pregnancy and breastfeeding
• Infants and young children

Monitoring

• Clinical response and extension of infection
• Irritation, contact sensitisation, or secondary fungal or resistant bacterial infection
• Local corticosteroid effects, particularly with large-area or occlusive use
• Possible withdrawal reaction after prolonged topical corticosteroid exposure

Clinical pharmacology

Hydrocortisone provides mild local glucocorticoid anti-inflammatory activity. Oxytetracycline acts against various susceptible Gram-positive and Gram-negative organisms. Dermal systemic-absorption data for oxytetracycline are unavailable; hydrocortisone absorption varies with area, occlusion and exposure length.

Formulation and product differences

• The selected product is a topical ointment containing liquid paraffin and white soft paraffin as excipients.
• It is not an ophthalmic preparation.