Medications (predominantly ointments and creams) which are applied to open wounds, or to already damaged tissue, represent a potential source for introduction of pathogens. The physician's confidence in modern pharmaceutical methods is such that he does not ordinarily think of these preparations in this light.
Pathogens may be introduced into ointments and creams in any of several ways:
From an infected site being treated, organisms may be carried back into the ointment jar during repeated applications.
From large (1 lb.) ointment jars on ward-maintained treatment carts used for several patients; the microbial sterility will depend upon the aseptic technique of several doctors, nurses, and aides.
Microbial contaminants, either fungi or bacteria, may be present in the preparation at the time of its arrival on the ward, in which case these agents either were present when received from the manufacturer or were introduced in the hospital pharmacy. Since
HARMON GA, SLUTZKER B, DAVIS A, EDMONDS P. Microbiology of Hospital Pharmacy Ointments. Arch Dermatol. 1962;85(4):510–516. doi:10.1001/archderm.1962.01590040074011
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