Neomycin Sulfate / Polymyxin B Sulfate / Bacitracin Zinc

Pronunciation: NEE-oh-MYE-sin SUL-fate/POL-ee-MIX-in SUL-fate/BAS-i-TRAY-sin zink
Class: Antibiotic combination

Trade Names

Neomycin/Polymyxin B Sulfate/Bacitracin Zinc
- Ointment, ophthalmic neomycin 3.5 mg/g, polymyxin B sulfate 10,000 units/g, bacitracin zinc 400 units/g

Neosporin
- Ointment, topical neomycin 3.5 mg/g, polymyxin B sulfate 5,000 units/g, bacitracin zinc 400 units/g

Neosporin Ointment (Canada)

Pharmacology

Bacitracin

Interferes with bacterial cell wall synthesis by inhibiting regeneration of phospholipid receptors involved with peptidoglycan synthesis.

Neomycin

Inhibits protein synthesis by binding to ribosomal RNA, causing bacterial genetic code misreading.

Polymyxin B

Interacts with phospholipid components of bacterial cell membrane, increasing cell wall permeability.

Indications and Usage

Ophthalmic

For the topical treatment of superficial infections of the external eye and its adnexa caused by susceptible bacteria. These infections include conjunctivitis, keratitis and keratoconjunctivitis, and blepharitis and blepharoconjunctivitis.

Topical

First aid to help prevent infections in minor cuts, scrapes, and burns.

Contraindications

None well documented.

Dosage and Administration

Superficial Eye Infections
Adults

Ophthalmic Apply every 3 to 4 h for 7 to 10 days.

First Aid
Adults and Children

Topical Apply a small amount on the affected area 1 to 3 times daily.

General Advice

  • Ophthalmic
  • For ophthalmic use only. Not for use in the ears or on the skin, or as injection into the eye.
  • Do not allow tip of tube to touch eye, eyelid, fingers, or any other surface.
  • If using other topical ophthalmic medications, instill drops first, wait at least 5 min, and instill ointment last.
  • Topical
  • For external use only. Not for use in the eyes.
  • Do not use over large areas of the body.
  • Clean the affected area before use.
  • Affected area may be covered with a bandage after application.

Storage/Stability

Ophthalmic

Store between 59° and 86°F.

Topical

Store between 68° and 77°F.

Drug Interactions

None well documented.

Adverse Reactions

EENT

Allergic sensitivity (itching, swelling, and conjunctival erythema)

Miscellaneous

Hypersensitivity reactions, including anaphylaxis (rare); local irritation on instillation.

Precautions

Monitor

During long-term use, monitor for signs of a sensitization reaction.


Pregnancy

Category C .

Lactation

Undetermined.

Children

Safety and efficacy not established for the ophthalmic ointment.

Hypersensitivity

Cutaneous sensitization may occur, particularly manifested as itching, reddening, and edema, or as a failure to heal.

Special Risk Patients

Advise patients with deep or puncture wounds, animal bites, or serious burns to contact their health care provider before using.

Superinfection

Prolonged use may result in bacterial or fungal overgrowth of nonsusceptible microorganisms.

Corneal wounds

Use may retard corneal wound healing.

Cross-sensitivity

Allergic cross-sensitivity to kanamycin, paromomycin, streptomycin, and, possibly, gentamicin may occur.

Resistance

Bacterial resistance to these antibiotics may develop.

Secondary infection

Secondary bacterial ocular infection following suppression of host responses may occur.

Patient Information

  • Teach patient, family, or caregiver proper technique for instilling ointment: wash hands and do not allow tip of tube to touch eye, eyelid, fingers, or any other surface. Pull lower eyelid down to form pocket; place prescribed amount of ointment in the pocket. Gently close eye; do not rub eye.
  • Advise patient, family, or caregiver that if more than 1 topical ophthalmic drug is being used, instill eye drops first, wait at least 5 min, and then instill ointment last.
  • Inform patient that temporary blurred vision and stinging of the eye are the most common adverse reactions and to contact health care provider if these symptoms occur and are bothersome.
  • Advise patient to contact eye doctor if eye or eyelid inflammation is noted or if eye symptoms do not improve or if they worsen.
  • Advise patient that the entire course of therapy must be completed to ensure max benefit and to complete full course of therapy, even if symptoms have resolved.
  • Instruct patient not to wear contact lenses during treatment.
  • Remind patient, family, or caregiver that follow-up eye examinations may be necessary while using this medication and to keep appointments.
  • Advise patients using the topical ointment to stop use and contact their health care provider if they need to use the ointment for longer than 7 days, if their condition persists or worsens, or if a rash or other allergic reaction develops.

Copyright © 2009 Wolters Kluwer Health.

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