The Disadvantages of Long-Term Oral Antibiotic Use: Exploring Alternatives in Topical Delivery Forms

The Disadvantages of Long-Term and repeat use of Oral Antibiotics: Exploring Alternatives in Topical Delivery Forms

In recent years, long-term and repeat use of antibiotics has become a common practice in the medical world. While antibiotics have undoubtedly revolutionized healthcare, allowing us to combat infectious diseases, chronic or repeat use does not come without downsides.

The Problem with Oral Antibiotics

When it comes to addressing superficial infections such as infections of the sinus, ear, or external wounds, systemic use of medications through the oral route can pose challenges such as:

  • Systemic delivery dilutes the concentration of a medication dramatically (40 liters in the average adult)
  • Development of antibiotic resistance
  • Microbiome disruption (the health promoting bacteria of the GI tract)
  • Other adverse side effects

Topical Delivery of Antibiotics: Breakthrough Alternative

Experienced compounders at Health Dimensions Clinical Pharmacy have developed alternative delivery methods for antibiotics via the topical delivery route at the actual site of infection (through ointments, lotions, creams, nasal sprays, or powders) versus by mouth (swallowed, bodywide delivery).

Topical delivery of antibiotics allows high drug concentration to reach the desired site of action without causing the systemic/body wide exposure that may result in challenges and side effects mentioned with oral antibiotics.

    Possible Advantages of Topical Compounded Medications

    Concentrated Medication at the Site of Action

    When the site of action is appropriate for topical delivery, medication can be delivered in the concentration needed to resolve the (chronic or longstanding) infection quickly and likely without systemic exposure.

    Systemic delivery of oral medications can lead to significant dilution throughout the body, reducing the concentration of the drug reaching the desired site of action. 

    The average adult contains 40 Liters of fluid that oral medication is diluted, meanwhile it is delivered to peripheral target sites. Compounded topical medications bypass this dilution effect by delivering high drug concentrations directly to the target area. 

    Minimizing Systemic Side Effects

    Oral medications have the potential to cause unwanted side effects due to their dilution and widespread distribution throughout the body. Compounded topical medications, on the other hand, offer a localized option of high concentration that minimizes systemic exposure which could reduce the risk of systemic side effects. By focusing solely on the affected area, topical delivery allows for the resolution of infections without the unnecessary burden of bodywide exposure to medications.

    Enhanced Results Potential

    Chronic or longstanding infections can be particularly challenging to address. Systemic medications may require prolonged use, increasing the risk of developing drug resistance and potentially causing side effects. By delivering medications directly to the site of action, compounded topical medications may quickly resolve infections without the need for extended antibiotic use. This targeted approach may save time, reduce the risk of complications, and promote faster healing.

    A great example of a situation where topical delivery would be more appropriate than oral delivery is antibiotics needed for a wound infection or sinus infection

    As highlighted in the table above comparing the wound healing results, topical antibiotics showed faster healing times and healing success rates.

    Topical Antibiotics, Custom Compounded by HDRX

    Pharmacists at Health Dimensions Clinical Pharmacy (HDRX) work closely with healthcare providers to formulate topical medications tailored to every individual patient, considering factors such as the type or location of infection, patient preferences, and other unique considerations. This personalized approach drives optimal outcomes while potentially minimizing the risk of side effects.

    At HDRX, we understand the importance of personalized care and tailored therapies. Our expert pharmacists are committed to high quality and standards. Working closely with healthcare providers and patients, we deliver high-quality compounded topical medications, including antibiotics for all types of infections. Trust us to be your partner in excellent health and wellness.

    Need Answers? Call HDRX: (800) 836-2303


    Daneman N, Gruneir A, Bronskill SE, et al. Prolonged Antibiotic Treatment in Long-term Care: Role of the Prescriber. JAMA Intern Med. 2013;173(8):673–682. doi:10.1001/jamainternmed.2013.3029.

    Kesavelu, D., & Jog, P. (2023). Current understanding of antibiotic-associated dysbiosis and approaches for its management. Therapeutic advances in infectious disease, 10, 20499361231154443.

    Llor, C., & Bjerrum, L. (2014). Antimicrobial resistance: risk associated with antibiotic overuse and initiatives to reduce the problem. Therapeutic advances in drug safety, 5(6), 229–241.

    Raban, M., Gates, P., Gasparini, C., & Westbrook, J. (2021). Temporal and regional trends of antibiotic use in long-term aged care facilities across 39 countries, 1985-2019: Systematic review and meta-analysis. PLoS One, 16(8), e0256501.

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