Neomycin Sulfate + Bacitracin Zinc + Polymyxin B Sulfate
Ointment may be used in the treatment of infected wounds,burns or skin grafts, and it is also of value in the preparation of donor sites for skin grafting and in the prevention of infection of extensive burns and contaminated wounds. It is of value in the local treatment of chronicvaricose or other indolent ulcers. The preparation is also of value in thetreatment of furuncles, carbuncles, pyoderma, sycosis barbae, impetigo and acne. It has also been used in dealing with secondary infected skin lesions of scabies, pediculosis, tinea pedis and contact and allergic dermatitis.
Topical Antibiotic preparations
Neomycin, an aminoglyoside with antimicrobial spectrum similar to gentamicin, binds to the 30S subunits of the bacterial ribosome, inhibiting protein synthesis and thereby disrupting DNA synthesis. It is active against many gram negative aerobes and against some strains of staphylococci.
Bacitracin inhibits bacterial cell wall synthesis and is active against many gram-positive bacteria (e.g. staphylococci, streptococci, corynebacteria and Clostridia) and some gram-negative species (e.g. Neisseria and Haemophilus influenzae). They are often found in combinations in topical preparations as broad spectrum antibacterial agents.
Polymyxin B disrupts the bacterial cytoplasmic membrane of mostly gram positive organisms allowing leakage of intracellular constituents by binding to membrane phospholipids.
Dosage & Administration
Topical: This ointment should be applied thinly over the affected area after cleaning it. One to three daily applications should be continued until the infection is controlled and healing complete.
This ointment should not be used in individuals who have shown sensitivity to any of the components. A possibility of increased absorption exists in very young children, thus this ointment is not recommended for use in neonates. Hypersensitivity.
Common side effects are Nausea; Vomiting; Pain, burning, or swelling; Skin rashes; Possible kidney problems; Hearing loss; Dizziness; Unusual numbness of the skin; Muscle twitching; Seizures; Pain; Redness; Swelling at the injection site.
Pregnancy & Lactation
Pregnancy category C. There is little information to demonstrate the possible effect of topically applied neomycin in pregnancy and lactation. However, neomycin present in maternal blood can cross the placenta and may give rise to a theoretical risk of fetal toxicity, thus this ointment is not recommended in pregnancy and lactation.
This ointment is not intended for sterile use in surgical procedures such as those involving abdominal or thoracic cavities as there is evidence that neomycin, when in contact with peritoneal or pleural tissues, can potentiate neuromuscular block in patients under the influence of muscle relaxants, producing respiratory paralysis. As with other antibiotic preparations prolonged use may result in overgrowth of non- susceptible organisms. Ototoxicity to neomycin has been reported.
In neonates and infants, absorption by immature skin may be enhanced and renal function may be immature.
Use in Special Population
Children and Infants: This ointment is suitable for use in children at the same dose as adults, but the dose should be reduced in infants. This ointment is not recommended for use in neonates.
Store below 30˚C. Keep all medicine out of reach of children.