Do I need to use two tubes of antibiotic eye ointment?

December 2, 2008 6:05 PM

The pediatrician says my two-week-old baby has a potential eye infection-- her left eye isn't draining properly yet. The pediatrician prescribed erythromycin ointment. Coincidentally, about three weeks ago, our cat was prescribed erythromycin for her eye infection, which is now long cleared. I still have about four-fifths of a tube. Is there any reason that I shouldn't use the cat's ointment on the baby? It seems like a waste to open another tube of the stuff.
posted by Mayor Curley to health & fitness (34 comments total)

You're joking, aren't you? This is your daughter's EYE. That's not worth a fresh tube of ointment?
posted by Kangaroo at 6:09 PM on December 2, 2008 [15 favorites]

In theory, sure, why not? In reality, ick, plus, there could be a meaningful difference. For any questions about medications, ask a pharmacist. They hear incredibly interesting questions all the time, and are trained to give the answers.
posted by theora55 at 6:11 PM on December 2, 2008

Yeah, it's not worth taking a chance of getting some kitty germ/virus in her eye.
posted by lee at 6:11 PM on December 2, 2008

I'd open a new tube because we're talking 2 week old infant, here. What's the upside in experimenting?

Hang onto the cat's erythromycin for the cat as those eye infections come back unexpectedly and you'll be glad you have the rest of the tube on hand.
posted by jamaro at 6:16 PM on December 2, 2008 [1 favorite]

In all likelihood it's the same stuff--veterinary medicine is often identical to human medicine--but it's generally a bad rule to take medicines prescribed for other humans because of the issue of dosage. There's no telling what dosage of some random other medicine is right for your child without bringing it in to your doctor. Without him looking at it you've no way of telling whether it's prepared at the same strength.

I'd say get him to look at it, and if he says it's okay, get him to write out a scrip for that, so you know how much/how often to use it. He'll likely take a look at it and say "Hey, that's what you'd get from the pharmacy, give x amount y times a day." But he may say "Actually, that's way too strong/not strong enough, go get a tube from the pharmacy.

Of course, he may also say "That's prepared in a solution not approved for human use, so no, don't use it."

In short: ask your doctor.
posted by valkyryn at 6:16 PM on December 2, 2008

It seems like a waste to open another tube of the stuff.

Would seem like a substantial waste of your daughter's eye to potentially infect it with whatever the cat had, no? (Besides the possibly different dosage and acceptable toxicity levels in a human and a cat?)
posted by gramcracker at 6:17 PM on December 2, 2008

I should point out for the people that have already contacted DSS that my wife picked up the fresh tube on the way back from the doctors' office and has administered ointment. But the frugal New Englander in me wonders "it's really the same stuff, isn't it? We're wasting antibiotics, right?"
posted by Mayor Curley at 6:17 PM on December 2, 2008 [3 favorites]

It wouldn't even be a good idea to use another human's eye ointment on a second person (there's a high potential for transfer of infection), so definitely don't use the cat's.
posted by amyms at 6:18 PM on December 2, 2008

Just curious. Did your wife think your notion was a good idea?
posted by sageleaf at 6:20 PM on December 2, 2008 [1 favorite]

...cheaper still: use breast milk as an eyewash. Mum can just aim and squirt.
posted by kmennie at 6:20 PM on December 2, 2008 [3 favorites]

Worst case: you're wasting like $1 of antibiotics. The concentrations and formulations might be different?
posted by a robot made out of meat at 6:22 PM on December 2, 2008

But the frugal New Englander in me wonders "it's really the same stuff, isn't it? We're wasting antibiotics, right?"

Tell your inner frugal New Englander that it's cheaper to waste the cat's antibiotic than it is to pay a huge medical bill when your baby gets a crazy hybrid feline/human eye disease.*

*although you could always recoup the money by selling the tragic story to the National Enquirer or Weekly World News.
posted by amyms at 6:23 PM on December 2, 2008

Cats' skins are said to have a different pH than human skin, to the point that human shampoo will burn them. I would guess that extends to the eye, but I didn't find anything to cite which said so directly.

If that's so, however, ointment formulated to match the pH of your cat's eyes could potentially burn your child's eyes.
posted by jamjam at 6:35 PM on December 2, 2008

It's a TWO-WEEK-OLD BABY. It has essentially nada as a defense against disease. And current theories on immunology suggest the eye glands are a pretty handy back entrance past many of our adult immune systems, anyway.

Suppose that a bacteria resistant to e-mycin has taken up residence in the compound (since it's been opened and fingered, and possibly refingered with cat germs, too).

All this is coming from Metafilter's resident "Oh, just eat it, it won't kill you!" guy.
posted by IAmBroom at 6:43 PM on December 2, 2008 [2 favorites]

I had a cousin who got an eye infection from a cat that no one noticed until one of her eyes was blind. Please don't mess around with your baby's eyes. Also, it's unlikely the that two creams are formulated exactly the same -- drug companies spend a lot of money figuring out the best ratio of the various components in a cream or pill.
posted by peacheater at 6:52 PM on December 2, 2008

It is in all likelihood exactly the same ointment, there's no special cat erythromycin. Which doesn't mean you should use it. It's not recommended to share eye ointments between individuals of ANY species because of cross-contamination potential. But, you know, good on you for looking to save the erythromycin trees. ;)
posted by biscotti at 7:03 PM on December 2, 2008 [2 favorites]

It would appear that the same product is used in pets and humans, if you look at Drs. Foster and Smith, a pet supply company, they sell Fougera brand erythromycin cream. If you look at Fougera's site they have information for human patients about the same cream.

But, as everyone else said, Jesus man just don't do it! Erythromycin is easily produced by extracting it from type of yeast. "Wasting" the rest of a tube has about as much environmental impact as throwing out a half a beer you accidentally left out overnight.
posted by TungstenChef at 7:19 PM on December 2, 2008 [1 favorite]

Wow, I am thrifty, but, WOW.
I think the biggest risk is if the strength of the preparation varies, and the potential that vet medicine uses different non-erythromycin ingredients in the ointment, how could you know?
If New England has gone post-apocalyptic, by all means use vet medicines rather than none, but if you already have the people tube...
posted by bystander at 7:24 PM on December 2, 2008

Hey man I'm just posting this cause everyone's on your case, but for the record I would have considered the same thing. I mean...come on? What's the harm in at least looking into it? Congratulations on having a baby! I hope she gets better soon and you guys get some sleep.
posted by jeb at 7:34 PM on December 2, 2008

As a frugal New Englander, I might experiment on myself treating a skin infection with the stuff, but I wouldn't experiment on my own eye, let alone someone else's.
posted by zippy at 7:39 PM on December 2, 2008

For the record veterinary terramycin antibiotic eye ointment successfully cleared my eye infection a couple of times. It was the quickest and least expensive treatment. I wouldn't recommend other people to use it, and certainly not on a kid or baby. But it worked fast, with my eyes well again overnight.
posted by anadem at 7:44 PM on December 2, 2008

Speaking as a frugal New Englander myself, even I'm saying, "but it's your child and it's her eye. That trumps frugality."
posted by EmpressCallipygos at 7:55 PM on December 2, 2008

Would you really feel comfortable taking a chance like this with your infant?

This is coming from someone who practically bathed himself in his dog's hydrocortisone to deal with poison ivy.
posted by rancidchickn at 8:03 PM on December 2, 2008

I'm seconding the suggestion from kmennie to use a little breast milk (if available) as an eyewash. Just another data point, but it worked for my son when he was just a couple of months old.
posted by lgandme0717 at 8:23 PM on December 2, 2008

Everything cats do is with malice aforethought. Don't let those languid eyes and twitchy whiskers fool you: the cat got an eye infection knowing it would be prescribed antibiotics which it knew you would be tempted to use on that bawling interloper (before it was born! add spooky prescience to the mix!) having first checked with the internets, thereby exposing yourself to ridicule and censure. Punish the cat by declawing its vet and relegating it to a life outside for the entire winter.

Congratulations on the baby. Pictures?
posted by firstdrop at 8:24 PM on December 2, 2008 [7 favorites]

"it's really the same stuff, isn't it?"

It isn't, necessarily. The rules about drugs for animals are more lax than for humans. There are drugs which are approved for veterinary use that are not approved for human use. And the standards for preparation and quality for veterinary drugs are not as strict.
posted by Class Goat at 8:29 PM on December 2, 2008

Why is everyone assuming that the cat stuff is contaminated? I'm guessing Curley didn't dip the frigging tip of it into his cat's eyeball. Why not assume it's just as "sterile" as the open container of baby stuff will be once someone's finger's on it? Sheesh.
posted by tristeza at 8:35 PM on December 2, 2008

totally not answering the question and violating AskMe but CONGRATS on the new baby Mayor Curley!

As others have said the general advice is don't share medications, even the nice cat's. And don't let your baby drive after applying the eye ointment because her vision may be impaired. Hope baby and kitty feel better soon.
posted by dog food sugar at 9:07 PM on December 2, 2008

It's the same stuff but you're not even supposed to use the same tube on the same animals different eyes, much less on two different animals (or babies). The applicator is an incredibly effective infection spreading device since you basically stick it into the eye.

So toss the cat's unused meds or return to the vet to be disposed of, you can't reuse them anyway.
posted by fshgrl at 9:20 PM on December 2, 2008

Congrats on the new baby!

As pretty much everybody has said, yeah, they're probably the same, and don't do it; I wanted to toss out a little cautionary tale also, though...

If the tube says that it's just erythromycin, then that's probably what it is, but a whole lot of antibiotic ointments prescribed for dogs and cats also have a steroid component. Which works great for dogs and cats -- but on horses or humans, the addition of steroids can be like throwing gasoline on a fire and can make an infection much worse.

A veterinary ophthalmologist friend of mine years ago used to tell a horror story of about a colleague of his who had a minor eye infection and without thinking much about it used some of this stuff on himself, and woke up the next day blind in that eye.

It's always worth remembering that in some fundamental respects, pet immune systems and human immune systems operate differently -- unless you really, really know what you're doing, don't share meds back and forth.
posted by nonliteral at 10:18 PM on December 2, 2008

I have relatives by marriage who are veterinarians, who, for both major and minor complaints have been known to use vet prescription drugs to treat their own (and some of their relatives') health problems.

One notable one treated his own cancer with pet-formulated pain medication until it was too late to do a normal human medical intervention for that cancer, but that wasn't a failing in the medicine, but in the person, in my opinion.

I am not a doctor or a veterinarian, but as far as I understand it, the veterinarian formulations are essentially the same except in the case of orally administered medication that is flavored and meant to be chewed or swallowed in non-pill form. For instance, a syrup or oil additive, or a chewable oral administration, where dogs, cats and humans have different flavorings and textures involved in their own formulations.

In general, humans probably won't enjoy the same flavors dogs or cats would (though I've been known to enjoy a milk bone or two as a kid).

It should also be noted that there are formularies both for humans and for dogs, cats and other veterinary patients that will actually create administerable drugs in formats that are different from standard (whether different flavoring, matrix substance - i.e. the oil or pill filler used to contain the dosage, etc.), that are usually available in major metropolitan areas and by mail order, to help administer drug doses to challenging patients. Their services are, I assume, more expensive than buying and using pre-made formulations.

If I were in your place, I would probably have used the cat lotion after inspecting the lotion for any other undesirable active ingredients. If I found that it was just erythromycin, I probably would have used it.

That said, what you really want to look out for with antibiotic anything is the possibility of running out of the supply in mid-treatment. That can make an infection much worse by essentially training the bacteria to become stronger and more immune to the medication, and harder to treat. It can also lead to mutations getting into the population and making it harder for everyone to treat that infection in the future. For that reason, I would probably fill the human prescription too, to avoid the risk of running out.
posted by kalessin at 2:08 PM on December 3, 2008

Thanks to your question I learned that the exact tube of Erythromycin 0.5% Ophthalmic Ointment I've been prescribed for a recurring eye injury is available on the veterinary site posted by TungstenChef, I can order from there if I'm running low, instead of finding my way to the doctor, blind in one eye. Although this benefits me, I would also give the advice of not using the cat ointment for the baby, assuming you opened the tube and used it on the cat. It is nearly impossible to get that goo into my own eye without contaminating the tip, or leaving a remnant of the goo which may also have touched my eye. While I have every confidence that this erythromycin goo is suitable for human use, it can be contaminated by other infectious agents that aren't killed by erythromycin such as viruses or parasites. I'm usually one to try to conserve even the tiniest of resources, but I wouldn't risk the cross-contamination in this case.
posted by ...tm... at 10:45 PM on December 9, 2008

Thanks to your question I learned that the exact tube of Erythromycin 0.5% Ophthalmic Ointment I've been prescribed for a recurring eye injury is available on the veterinary site posted by TungstenChef, I can order from there if I'm running low, instead of finding my way to the doctor, blind in one eye.

I'm afraid not, medications that work on both humans and animals require a prescription to prevent doing exactly what you want to do. Drs. Foster and Smith will require proof from a vet, and if you think faking it isn't a bit deal, it's probably a felony in your state because of drug diversion laws. Not to mention that it's probably a good idea to get a 2nd opinion if you have a recurring infection that your doc hasn't been able to fix.
posted by TungstenChef at 11:51 PM on December 9, 2008

My wife, a pharmacist (not a vet pharmacist and not your pharmacist, mind) says risk of infection alone would be reason enough not to reuse any ointment, human or animal.
posted by wheat at 11:47 AM on December 21, 2008