Neomycin/polymyxin B/bacitracin, also known as triple antibiotic ointment, is a medication used to reduce the risk of infections following minor skin injuries. It contains three antibiotics: neomycin, polymyxin B, and bacitracin. It is for topical use only and should not be ingested due to risk of kidney damage. Possible side effects include itchiness and skin rash, and in rare cases hearing loss. Use in pregnancy is generally recommended. It is relatively broad spectrum, being effective against both Gram-negative and Gram-positive bacteria. The combination was approved for medical use in the United States in 1971. It is available over the counter in the United States. In 2020, it was the 409th most commonly prescribed medication in the United States, with more than 100thousand prescriptions. Medical uses Neomycin/polymyxin B/bacitracin ointment is reported to be a safe and effective topical agent for preventing infections in minor skin trauma. It is used for burns, scratches, cuts, and minor skin infections. The ointment is most effective when applied after cleaning the affected area. The use of neomycin/polymyxin B/bacitracin, decreases infection rates in minor-contaminated wounds. However, if the wound is sterile, then there are no benefits compared to petrolatum (placebo). Side effects It is for external use only and should not be applied near mucous membranes such as the eyes or mouth. It is not recommended for children under the age of two. Users should immediately seek medical attention if they experience hives, rashes, or itching. Any skin irritations such as pain, burning, or cracked skin that were not present prior to use of ointment must receive immediate care. It has been shown to cause contact dermatitis in some cases. Antibiotic-resistant bacteria Concern exists that its use contributes to the emergence of antibiotic-resistant bacteria. In the US, the only large market for the ointment, it may increase antibiotic resistance. For instance, it may increase the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) bacteria, specifically the highly lethal ST8:USA300 strain. Components The original ointment contains three different antibiotics: bacitracin, neomycin, and polymyxin B, in a relatively low-molecular-weight base of cocoa butter, cottonseed oil, sodium pyruvate, tocopheryl acetate, and petroleum jelly. The generic name for these products, regardless of the base, is "triple antibiotic ointment". In China, the product (with lidocaine) is named "compound polymyxin B ointment" and is manufactured there by Zhejiang Fonow Medicine Co. Ltd. The product was also marketed by the Upjohn Company under the name