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Bacitracin contact allergy in Zagreb

Although Dr. Aberer, Dr. James, Dr. Walling reported in JAAD (2005) and Smack et al in JAMA (1996) (1-4) regarding the risk and benefits of the use of antibiotic-containing ointment during and after cutaneous surgery, we reviewed high hypersensitivity to neomycin over a three-year period (1990-1992) (5). We recorded allergic contact dermatitis (ACD) from neomycin (5.00%, 6.69, 10.18%) in atopic dermatitis, seborrhoeic dermatitis patients, psoriasis vulgaris and patient with hypostasic dermatitis (5). In Allergy Clinic of the University Department of Dermatology and Venerology School of Medicine, the frequency of contact allergy to bacitracin (neomycin) was increased during the years: in 2003 was registered 15.94%, in 2004 11.37%, in 2005 13.64 and in 2006 9.04% . Bacitracin- containing ointments began to be recommended in hypostasic ulcers as well as in chronic wound and postsurgical wound dressing in late 1990s. Neomycin-induced ACD and neomycin as a top allergen was seventh most common allergen during the year 2000-2002 (1). Otitis externa should not be treated with topics containing neomycin or other aninoglycoside antibiotic because if possible cross-reactions with other allergens (p-amino benzoic acid, erythromycin, chloramphenicol, gentamycin, fragrances). The application of proctological neomycin-containing topics is not to be recommended either. In the treatment of hypostasic ulcers we suggest that the use of neomycin-containing topics be avoided (5). In the study of Dr. David Smack was in the postsurgical setting expressed ADC in 1% exposed to bacitracin and he did not supported the need for antibiotic ointment as a part of postsurgical wound care (4) . Many authors support in post surgical treatment not the use of bacitracin-containing ointments because there is no infection preventing benefit (1).

allergic contact dermatitis; neomycin; bacitracin

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