Understanding Terra-Cortril's Active Ingredients
Terra-Cortril is a topical ointment that contains two main active components: oxytetracycline and hydrocortisone. Some formulations may also have included polymyxin B, especially older eye and ear versions.
Oxytetracycline: The Antibacterial Component
Oxytetracycline is a broad-spectrum tetracycline antibiotic that works by inhibiting bacterial protein synthesis, thereby preventing the growth of susceptible microorganisms. Its antibacterial activity makes it effective against a variety of both Gram-positive and Gram-negative bacteria commonly associated with skin infections. However, as with all antibiotics, resistance can develop over time, making it less effective against certain strains of bacteria.
Hydrocortisone: The Anti-inflammatory Component
Hydrocortisone is a mild corticosteroid, a type of steroid that reduces inflammation, itching, and swelling. By suppressing the body's immune response in the affected area, it helps to alleviate the symptoms of inflammatory skin conditions like eczema and dermatitis. Its addition to the ointment provides rapid relief from the discomfort associated with these conditions.
Primary Uses and Indications
As a combination product, Terra-Cortril ointment is prescribed to treat inflammatory skin conditions where a bacterial infection is present or suspected.
- Exudative and secondarily infected eczema: This includes both atopic and seborrhoeic eczema where the skin has been broken and subsequently infected by bacteria.
- Allergic and irritant dermatitis: Conditions caused by contact with irritants or allergens that have become secondarily infected.
- Infected insect bites: When an insect bite becomes inflamed and infected from scratching.
- Flexural intertrigo: The ointment can be used for up to seven days to treat this rash in skin folds if it is also exudative and secondarily infected.
It is important to note that Terra-Cortril was also formulated as an ophthalmic (eye) and otic (ear) suspension or ointment, but the skin ointment is not for use in the eyes and has different indications. The brand name Terra-Cortril has been discontinued, but generic equivalents or similar products may be available under different names.
Precautions and Contraindications
Several warnings and contraindications are associated with Terra-Cortril ointment that must be considered before use. A healthcare professional's guidance is essential.
General Precautions
- Avoid prolonged use: Extended application can lead to systemic absorption of the corticosteroid and increase the risk of side effects. It may also cause steroid withdrawal syndrome upon cessation.
- Masking effect: The steroid component can mask the signs of an underlying infection, particularly if it is viral or fungal. If no improvement is seen within a specified duration of treatment, the treatment should be stopped and a doctor consulted.
- Overgrowth of organisms: Use of the antibiotic can sometimes lead to an overgrowth of resistant organisms, including fungi like Candida or resistant bacteria like staphylococci.
Specific Contraindications
- Viral or fungal infections: The ointment should not be used on viral skin diseases (e.g., herpes simplex, varicella) or fungal infections of the skin.
- Pregnancy and breastfeeding: Due to the potential risks associated with tetracycline use, the ointment is contraindicated during pregnancy and breastfeeding.
- Infants and young children: Its use is not recommended for young children due to the risk of dental damage from the tetracycline component.
Off-Label Dental Use and Complications
Interestingly, some oral surgeons have historically used Terra-Cortril off-label for post-extraction dental issues, such as dry socket. However, recent studies and case reports have highlighted a significant risk of unsuccessful healing, with some patients developing inflammatory lesions containing a tar-like substance in the extraction socket. This suggests that Terra-Cortril can interfere with the natural healing process in certain applications and its off-label use is discouraged.
Comparing Terra-Cortril with Other Topical Treatments
It's useful to understand how Terra-Cortril compares to other combination topical treatments. While many contain hydrocortisone, the antibiotic component is often different.
| Feature | Terra-Cortril Ointment | Fucibet Cream (e.g.) | Lotrisone® Cream (e.g.) |
|---|---|---|---|
| Active Ingredients | Oxytetracycline (antibiotic) + Hydrocortisone (mild corticosteroid) | Betamethasone (strong corticosteroid) + Fusidic Acid (antibiotic) | Betamethasone (strong corticosteroid) + Clotrimazole (antifungal) |
| Primary Function | Treat inflammatory skin conditions with suspected bacterial infection | Treat inflammatory skin conditions with bacterial infections susceptible to Fusidic Acid | Treat fungal infections of the skin with associated inflammation |
| Strength | Mild corticosteroid | Strong corticosteroid | Strong corticosteroid |
| Microorganism Coverage | Broad-spectrum antibacterial (Gram-positive/negative) | Antibacterial (specifically Staphylococci and others susceptible to fusidic acid) | Antifungal against many fungi, some Gram-positive bacteria |
| Key Use Case | Infected eczema, dermatitis, insect bites | Severe infected dermatitis and eczema | Ringworm, jock itch, athlete's foot with inflammation |
Application Instructions and Usage
Before applying Terra-Cortril or a similar product, always follow a doctor's specific instructions. General guidelines based on package inserts include:
- Clean the area: The affected skin should be thoroughly cleansed before application.
- Apply gently: A small amount of the ointment should be gently applied to the affected area.
- Frequency: The frequency of application will be determined by a healthcare professional or indicated on the product labeling.
- Covering: A sterile gauze may be used to cover the area if an infection is present.
- Duration: The duration of treatment should not exceed the period recommended by a doctor, especially if the condition has not improved.
Conclusion
In summary, Terra-Cortril ointment, combining the antibiotic oxytetracycline and the corticosteroid hydrocortisone, is primarily used to treat inflammatory skin conditions like eczema, dermatitis, and infected insect bites when a secondary bacterial infection is present. While the brand name is no longer widely available, generic or similar combinations exist and require a prescription. Caution is necessary due to the potential for side effects, masking viral or fungal infections, and the risk associated with prolonged use. Always consult a healthcare professional to ensure it is the appropriate treatment and to follow correct usage guidelines.
An Outbound Link for Further Reading
For more detailed prescribing information and cautions, including adverse reactions, always consult authoritative medical sources or pharmacy leaflets. For instance, the electronic medicines compendium (emc) provides detailed information on Terra-Cortril ointment for the UK market: Terra-Cortril ointment - (emc) | 1995.
