[Pharmwaste] Prisoners using antibiotic ointment as hair gel -- why that's worrisome

DeBiasi, Deborah (DEQ) Deborah.DeBiasi at deq.virginia.gov
Thu Jun 7 11:52:50 EDT 2012


Prisoners using antibiotic ointment as hair gel -- why that's worrisome
By Diane Mapes

We've all had those fuzzy mornings where we've nearly brushed our teeth with Neosporin, but a new study presented at an annual meeting of epidemiologists has found that prison inmates are purposefully misusing over-the-counter topical antibiotics as grooming aids.

The study, which asked 822 inmates at two New York State prisons about their use of OTC antibiotics such as Bacitracin (an ingredient found in Neosporin), found that 29 percent of the men and 28 percent of the women had used the ointment for dry skin, 18 percent of men and 15 percent of women had used it as a lip balm, 8 percent of men and 3 percent of women had used it as hair gel and 6 percent of men had slathered the ointment onto their face as a shaving cream.

"I think one reason they used the antibiotic ointments in these ways is because they didn't know they shouldn't," says Carolyn Herzig, a PhD candidate in the Department of Epidemiology at the Mailman School of Public Health at Columbia University and lead author of the study. "Or it might be that they didn't have easy access to other products."

Misuse or overuse of antibiotics is worrisome because it can lead to strains of antimicrobial resistant pathogens resulting in the emergence of multi-drug resistant organisms such as MRSA,<file:///C:\Users\j-mdahl\AppData\Local\Microsoft\AppData\Local\Microsoft\Windows\Temporary%20Internet%20Files\AppData\Local\Microsoft\Windows\Temporary%20Internet%20Files\Content.Outlook\0VTJXS38\understanding-mrsa-methicillin-resistant-staphylococcus-aureus> a strain of staph infection that's now resistant to methicillin, amoxicillin, penicillin, oxacillin, and many other antibiotics.

These pathogens are already a problem in prisons, and the "misuse of antibiotics in these facilities might exacerbate this issue," Herzig explains.

"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," says Herzig. "That's exactly what the concern is."

Herzig and her team of researchers tapped prison inmates as they were being admitted to two New York State maximum security prisons -- one men's and one women's. (The researcher declined to reveal the names of the prisons.)

"The question we asked was, 'Have you used antibiotic ointment in the past six months?'" she says. "They were entering the prison facilities from either jails or prisons or possibly, the community. If they served a sentence longer than six months, then they had used the ointments in other prisons or in county lockup. It's also possible that some of them used the ointments while they were not incarcerated but I would say the majority of them used them while incarcerated."

Medical personnel do dispense antibiotic ointments to inmates as needed; however, other items -- such as hair gel and shaving cream -- are harder to come by, Robin Campbell, press secretary for the New York City Department of Corrections (which includes Rikers Island and other Borough facilities), said in a statement.

"Facility medical personnel dispense antibiotic creams and ointments, like foot gels, to inmates on an as needed basis," he said in an email. "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."

Antibiotic resistance concerns aside -- would a Neosporin-like cream even work as a beauty aid? "I think they probably worked as well as Vaseline," says Herzig. "And I really think if they'd had lotion or Vaseline, that's what they would have used."

The study's findings were presented this week at the 39th Annual Educational Conference and International Meeting of the Association for Professionals in Infection Control and Epidemiology in San Antonio, Texas. Funded by the National Institute of Allergy and Infectious Diseases, the study was the first of its kind to report on the widespread misuse of topical antibiotics among inmates.

While Herzig says she's been unable to find any studies on the misuse of over-the-counter antibiotic ointments in everyday life, she is curious about inappropriate use of these products in normal populations.

"I've spent a lot of time looking at the literature to see if there's a comparable study that shows how people use these ointments in a community, but I haven't seen anything that reports that information," she says. "I suspect it is happening, though."

Melissa Rowton<http://www.facebook.com/melissa.rowton>, a 41-year-old customer service trainer from Seattle, says she's used antibiotic ointments on blemishes before -- although she doesn't do it very often.

"I've used Neosporin for pimples and have a friend who swears by it," says Rowton. "It makes sense when they are often caused by bacteria. I wash and dry my face thoroughly and dab a small amount on any problem area before bed."

Herzig says none of the prisoners who answered the open-ended questionnaire indicated they'd used the antibiotic ointments in this way. However, in addition to using the topical antibiotics as hair gel, moisturizer and lip balm, many said they'd used the products in ways that were closer to their intended use.

"We got many reasons," she says. "Some used them for skin injuries, skin conditions including eczema and acne, fungal infection, or for new tattoos. We're not suggesting people should use antibiotics for all those reasons. But they're more appropriate than using them for lip balm or moisturizer."



Deborah L. DeBiasi
Email:   Deborah.DeBiasi at deq.virginia.gov
WEB site address:  www.deq.virginia.gov<http://www.deq.virginia.gov/>
Virginia Department of Environmental Quality
Office of Water Permit and Compliance Assistance Programs
Industrial Pretreatment/Whole Effluent Toxicity (WET) Program
PPCPs, EDCs, and Microconstituents  http://www.deq.virginia.gov/Programs/Water/PermittingCompliance/PollutionDischargeElimination/Microconstituents.aspx
Mail:          P.O. Box 1105, Richmond, VA  23218
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PH:         804-698-4028      FAX:      804-698-4032

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