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Study Finds Prisoners Inappropriately Using Topical Antibiotics

by David M. Reutter

Research into the use of topical antibiotics in correctional facilities found that prisoners frequently use antibiotics for reasons inconsistent with their recommended purpose.

A two-year study of 822 New York state prisoners was presented at the 39th Annual Educational Conference and International Meeting of the Association for Professionals in Infection Control and Epidemiology (APIC). Of the 421 male and 401 female prisoners in maximum-security facilities who participated in the study, 59% of the men and 40% of the women reported they had used topical antibiotics – ointments such as Bacitracin and Neosporin – within the previous six months.

Those prisoners who had used antibiotics reported using them inappropriately in the following ways: as a lotion for dry skin, 29% of men and 28% of women; as a lip balm, 18% of men and 15% of women; as hair grease, 8% of men and 3% of women; and for shaving, 6% of men.

Misuse of antibiotics can lead to the development of antimicrobial resistance, resulting in multidrug resistant organisms such as methicillin-resistant Staphylococcus aureus (MRSA). Multidrug resistant organisms cause a significant number of serious infections that are more difficult to treat because there are fewer – and in some cases no – antibiotics that will cure them.

“We don’t know specifically whether the overuse of topical antibiotics would lead to MRSA – we don’t have the data to demonstrate that – but in many cases, in general, the overuse and misuse of antibiotics can lead to antibiotic resistance,” said Carolyn Herzig, a Ph.D. candidate at Columbia University in New York City, who led the research team.

“Alternative products, such as lotion and ointments that do not contain antibiotics, are available to inmates, so this comes down to more awareness and better education for this group of people,” she added.

The misuse of topical antibiotics by prisoners is partly linked to policies that restrict the types of hygiene products available in prisons and jails. “Facility medical personnel dispense antibiotic creams and ointments, like foot gels, to inmates on an as needed basis,” said Robin Campbell, a spokesman for the New York City Department of Corrections. “Although inmates may purchase some personal hygiene products, like shampoo, toothpaste and deodorant, from the facility commissary, shaving cream, lip balm and hair gel are prohibited due to security concerns.”

Herzig noted that some prisoners had also reported using topical antibiotics for appropriate reasons, including to treat injuries and for skin conditions such as eczema, certain fungal infections and new tattoos.

“Ms. Herzig’s research highlights the need for education of all audiences about the prudent use of antibiotics, since multidrug resistant organisms pose significant risk to patient safety in many different settings, including correctional facilities,” stated APIC past president Michelle Farber.

The study, which was funded by the National Institute of Allergy and Infectious Diseases, concluded that interventions are warranted to reduce the inappropriate use of topical antibiotics among prisoners.


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