Skip to content
ClinCalc Pro
Menu
Calculators Drugs Pathways AI Dx Donate Get the App
Topical mild steroid + tetracycline antibacterial Pregnancy: UK SPC section 4.6: "Terra-Cortril Ointment is contra-indicated during pregnancy and in nursing mothers, because of the theoretical risk of damage to permanent dentition."

Hydrocortisone with oxytetracycline

Brand names: Terra-Cortril

Used in: Anaphylaxis & Allergy

This combination preparation contains the mild corticosteroid hydrocortisone with the tetracycline antibiotic oxytetracycline, used topically for inflammatory skin conditions with secondary bacterial infection.

Adult dose

Dose: A small amount of ointment applied gently to the affected skin areas after thorough cleansing
Route: Topical (cutaneous) — "Terra-Cortril Ointment is for topical administration only". Not recommended for ophthalmic use.
Frequency: Two to four times daily
VERBATIM UK SPC section 4.2: "After thorough cleansing of the affected skin areas, a small amount of the ointment should be applied gently. Applications should be made two to four times daily. Terra-Cortril Ointment is for topical administration only." No numeric dose ceiling is stated in section 4.2, so no maxDose has been entered. DURATION LIMIT (section 4.4): "Terra-Cortril Ointment should not be continued for more than seven days in the absence of any clinical improvement, since in this situation occult extension of infection may occur due to the masking effect of the steroid." "Extended or recurrent application may increase the risk of contact sensitisation and should be avoided." "If extensive areas are treated or if the occlusive technique is used, there may be increased systemic absorption of the corticosteroid and suitable precautions should be taken." "If irritation develops, the product should be discontinued." "The label will state mild steroid." ELDERLY (section 4.2): "No special precautions." RENAL OR HEPATIC IMPAIRMENT (section 4.2): "No special precautions." CHILDREN (section 4.2): "Not recommended. (See 'Contra-indications')." INTERACTIONS (section 4.5): "None established." NOT USED: the bundle's openFDA record is an unrelated US OTC hydrocortisone-only "anti itch" product (Meijer, Inc., 2024-09-17) that contains no oxytetracycline; its directions were deliberately excluded.

Dose independently re-sourced from UK Summary of Product Characteristics (SPC) via the eMC; US FDA prescribing information (openFDA / DailyMed) — cross-check; US labelling may differ from UK — clinician-reviewed. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

  • Hypersensitivity to one of the components of the preparation
  • Primary bacterial infections e.g. impetigo, pyoderma, furunculosis
  • Pregnancy
  • Lactation
  • Infants and small children, because of the theoretical risk of damage to permanent dentition
  • Section 4.2: use in children is not recommended
  • Section 4.4: not recommended for ophthalmic use

Side effects

  • Allergic reactions, including contact dermatitis, may occur occasionally but are rare
  • Allergic sensitisation — the reaction occurring most often from the presence of the anti-infective ingredient
  • Local corticosteroid effects, especially under occlusive dressings: burning, itching, irritation, dryness, folliculitis, hypertrichosis, acneiform eruptions, hypopigmentation, perioral dermatitis, allergic contact dermatitis, maceration of the skin, secondary infection, skin atrophy, striae, miliaria
  • Secondary bacterial or fungal infection has occurred after use of combinations containing steroids and antimicrobials
  • Overgrowth of resistant organisms, particularly Candida and staphylococci (section 4.4)
  • Topical steroid withdrawal syndrome — rebound flare after stopping long-term topical steroid use, which can take the form of a dermatitis with intense redness, stinging and burning that can spread beyond the initial treatment area, and is more likely at delicate sites such as the face and flexures (section 4.4)

Monitoring

  • Discontinue if there is no clinical improvement within seven days — occult extension of infection may be masked by the steroid (section 4.4)
  • Observe carefully for overgrowth of resistant organisms, particularly Candida and staphylococci; discontinue if new infections due to non-susceptible bacteria or fungi appear during therapy (section 4.4)
  • Take suitable precautions against increased systemic corticosteroid absorption if extensive areas are treated or an occlusive technique is used (section 4.4)
  • Discontinue if irritation develops (section 4.4)
  • Suspect topical steroid withdrawal if the condition recurs within days to weeks after successful treatment; reapply with caution and seek specialist advice or consider other treatment options (section 4.4)

Clinical monograph

How it works

Hydrocortisone reduces local inflammation via glucocorticoid receptors, while oxytetracycline inhibits bacterial protein synthesis by binding the 30S ribosomal subunit.

Prescribing in practice

  • Limit to short-term use for infected inflammatory dermatoses to avoid steroid atrophy and reduce antibiotic resistance; it is not appropriate for inflammation without infection.
  • Be aware the preparation may stain skin or clothing.
  • Avoid prolonged or repeated application on the face and flexures.

Monitoring

Review the treated area for resolution of infection and inflammation and step down once it has settled.

Counselling the patient

  • Apply thinly to the affected area for the short course only.
  • The preparation may stain fabrics, so take care with clothing and bedding.
  • Return if the condition spreads or fails to improve.

Evidence & guidelines

Topical steroid-antibiotic combinations are reserved for inflammatory skin disease with secondary infection in line with standard prescribing references.

Reference: Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

Calculators
Pathways