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Bacitracin, Neomycin, and Polymyxin B (Topical)

Pronunciation

(bas i TRAY sin, nee oh MYE sin, & pol i MIKS in bee)

Index Terms

  • Neomycin, Bacitracin, and Polymyxin B
  • Polymyxin B, Bacitracin, and Neomycin
  • Triple Antibiotic

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Ointment, External:

Medi-First Triple Antibiotic: Bacitracin 400 units, neomycin 3.5 mg, and polymyxin B 5000 units per g (1 ea)

Neosporin Original: Bacitracin 400 units, neomycin 3.5 mg, and polymyxin B 5000 units per g (1 ea, 14.2 g, 15 g, 28.3 g)

Triple Antibiotic: Bacitracin 400 units, neomycin 3.5 mg, and polymyxin B 5000 units per g (1 ea, 1 g, 9.4 g, 14 g, 14.2 g, 15 g, 28 g, 28.4 g, 30 g, 453.9 g)

Generic: Bacitracin 400 units, neomycin 3.5 mg, and polymyxin B 5000 units per g (1 ea, 15 g, 28.35 g)

Brand Names: U.S.

  • Medi-First Triple Antibiotic [OTC]
  • Neosporin Original [OTC]
  • Triple Antibiotic [OTC]

Pharmacologic Category

  • Antibiotic, Topical

Pharmacology

See individual agents.

Use: Labeled Indications

Topical infection prevention: Prevention of infection in minor cuts

Contraindications

Hypersensitivity to neomycin, polymyxin B, zinc bacitracin, or any component of the formulation; mycobacterial or fungal infections; topical ointments for external use only

Dosing: Adult

Topical infection prevention: Topical: Apply 1 to 3 times/day to infected area; may cover with sterile bandage if necessary.

Dosing: Geriatric

Refer to adult dosing.

Dosing: Pediatric

Topical infection prevention: Children and Adolescents: Refer to adult dosing.

Dosing: Renal Impairment

There are no dosage adjustments provided in the manufacturer’s labeling. However, dosage adjustment unlikely due to low systemic absorption.

Dosing: Hepatic Impairment

There are no dosage adjustments provided in the manufacturer’s labeling. However, dosage adjustment unlikely due to low systemic absorption.

Drug Interactions

There are no known significant interactions.

Adverse Reactions

Frequency not defined.

Dermatologic: Reddening, allergic contact dermatitis

Local: Itching, failure to heal, swelling, irritation

Miscellaneous: Anaphylaxis

Warnings/Precautions

Dosage form specific issues:

• Topical ointment: When used for self-medication (OTC use), patients should notify healthcare provider if needed for >1 week. Should not be used for self-medication on deep or puncture wounds, animal bites, or serious burns. Not for application to large areas of the body.

Pregnancy Risk Factor

C

Pregnancy Considerations

Animal reproduction studies have not been conducted with this combination.

Patient Education

• Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)

• Patient may experience redness or itching. Have patient report immediately to prescriber edema or severe skin irritation (HCAHPS).

• Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.

Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for health care professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience, and judgment in diagnosing, treating, and advising patients.

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