FULL CLAIM: Swabbing nostrils with triple antibiotic cream or gel will prevent the flu
The meme containing this claim was published on Facebook in early December 2019 and went viral in January 2020, receiving more than 200,000 views to date. It claims that swabbing triple antibiotic cream or gel in the nostrils can help people avoid the flu.
Scientists who reviewed the claim explained that antibiotics are only able to kill bacteria but are not able to act on viruses. Because influenza is caused by a virus, it is not possible for antibiotic cream to prevent someone from catching the flu. Furthermore, such indiscriminate use of antibiotics fuels antibiotic resistance, which results in currently available antibiotics becoming ineffective on once-treatable bacterial infections, as in the cases of methicillin-resistant Staphylococcus aureus and extensively drug-resistant tuberculosis. Antibiotic resistance is now a major problem in healthcare systems, leading to “longer hospital stays, higher medical costs and increased mortality”.
There is no scientific data to support the claim that triple antibiotic ointment or cream helps prevent influenza. Antibiotic ointment helps kill bacteria, but influenza is a virus, so the ointment or cream will have no killing activity against the virus.
It is well established, both empirically (by clinical outcome in patients) and experimentally (in tests with infected cells) that antibiotics have no activity against viruses.
I thought that would be the end of the story but, interestingly, there is a paper that demonstrated enhanced host resistance to viral infection when certain antibiotics were applied to the mouse vaginal mucosa, or in cultured cells. The authors proposed that this worked by inducing host innate antiviral mechanisms, such as the interferon system. One of the antibiotics they used was neomycin (included in the triple antibiotic ointment). Although intriguing (and, as far as I can tell, good work scientifically), I don’t think it’s anywhere near sufficient to justify the real dangers from the indiscriminate use of antibiotics, especially the risk of increasing antibiotic resistance.
Otherwise, I haven’t been able to find scientific evidence to suggest that nasal application of antibiotic cream or ointment prevents flu or other respiratory infections, as opposed to the large body of evidence that these antibiotics have no effect on the virus.
However, there is a broad consensus, as well as considerable evidence, that antibiotics are overused in viral upper respiratory tract infections, and confer little or no clinical benefit[2,3,4]. There is a well-founded concern that inappropriate use, or overuse, of antibiotics can promote antimicrobial resistance in bacteria[2,6], and antibiotic use should therefore be avoided when not necessary[2,5].
Until recently, we had very few effective antiviral agents. We now have a few for influenza, but even these are recommended for use in advance of exposure only in certain circumstances, and usually recommended primarily when vaccination is not feasible. Our first line of defense for flu remains the flu vaccine, together with good hygienic measures such as staying home and away from others when sick, covering coughs and sneezes, etc.
We previously analyzed an article by Time, found by reviewers to be accurate, which described how to differentiate the flu and the common cold, as well as how to avoid catching and spreading the flu.
The World Health Organization published infographics in 2017 explaining how antibiotic resistance arises and how we can play a role in mitigating it.
- 1 – Gopinath et al. (2018) Topical application of aminoglycoside antibiotics enhances host resistance to viral infections in a microbiota-independent manner. Nature Microbiology.
- 2 – Harris et al. (2016) High Value Care Task Force of the American College of Physicians and for the Centers for Disease Control and Prevention. Appropriate Antibiotic Use for Acute Respiratory Tract Infection in Adults: Advice for High-Value Care From the American College of Physicians and the Centers for Disease Control and Prevention. Annals of Internal Medicine.
- 3 – Havers et al. (2018) Outpatient Antibiotic Prescribing for Acute Respiratory Infections During Influenza Seasons. JAMA Network Open.
- 4 – Essack et al. (2019) Topical (local) antibiotics for respiratory infections with sore throat: An antibiotic stewardship perspective. Journal of Clinical Pharmacy and Therapeutics.
- 5 – Harper et al. (2009) Seasonal Influenza in Adults and Children — Diagnosis, Treatment, Chemoprophylaxis, and Institutional Outbreak Management: Clinical Practice Guidelines of the Infectious Diseases Society of America. Clinical Infectious Diseases.
- 6 – Guitor and Wright. (2018) Antimicrobial Resistance and Respiratory Infections. Chest.