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Bacitracin, Neomycin, Polymyxin B, and Hydrocortisone (Topical)

Medically reviewed by Last updated on Sep 14, 2020.


(bas i TRAY sin, nee oh MYE sin, pol i MIKS in bee, & hye droe KOR ti sone)

Index Terms

  • Hydrocortisone, Bacitracin, Neomycin, and Polymyxin B
  • Neomycin, Bacitracin, Polymyxin B, and Hydrocortisone
  • Polymyxin B, Bacitracin, Neomycin, and Hydrocortisone

Dosage Forms

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

Ointment, External:

Cortisporin: Bacitracin 400 units, neomycin 3.5 mg, polymyxin B 5000 units, and hydrocortisone 10 mg per g (15 g)

Brand Names: U.S.

  • Cortisporin

Pharmacologic Category

  • Antibiotic, Topical
  • Corticosteroid, Topical


See individual agents.

Use: Labeled Indications

Superficial dermal infection: Treatment of corticosteroid-responsive dermatoses with secondary infection


Hypersensitivity to bacitracin, neomycin, polymyxin B, hydrocortisone, or any component of the formulation; tuberculous, fungal, or viral (eg, herpes simplex, varicella zoster) skin lesions; application in eyes or external ear canal in patients with perforated eardrum.

Dosing: Adult

Superficial dermal infection: Topical: Apply thin film to affected area 2 to 4 times daily for up to 7 days.

Dosing: Geriatric

Refer to adult dosing.

Dosing: Pediatric

Superficial dermal infection: Limited data available: Children and Adolescents: Topical: Apply a thin film to affected area 2 to 4 times daily for up to 7 days (Bradley 2015).


Topical: For external use only; avoid use in eyes.


Store at 15°C to 25°C (59°F to 77°F).

Drug Interactions

Aldesleukin: Corticosteroids may diminish the antineoplastic effect of Aldesleukin. Avoid combination

Calcipotriene: Hydrocortisone (Topical) may diminish the therapeutic effect of Calcipotriene. Management: Monitor for reduced calcipotriene efficacy if combined with hydrocortisone valerate. Consider separating the administration of these agents by 10 to 12 hours to minimize the risk of this potential interaction. Monitor therapy

Adverse Reactions

See individual agents.


Concerns related to adverse effects:

• Adrenal suppression: Systemic absorption of topical corticosteroids may cause hypercortisolism or suppression of hypothalamic-pituitary-adrenal (HPA) axis, particularly in younger children or in patients receiving high doses for prolonged periods. HPA axis suppression may lead to adrenal crisis.

• Immunosuppression: Prolonged use of corticosteroids may also increase the incidence of secondary infection, mask acute infection (including fungal infections), prolong or exacerbate viral infections, or limit response to vaccines.

• Kaposi sarcoma: Prolonged treatment with corticosteroids has been associated with the development of Kaposi sarcoma (case reports); if noted, discontinuation of therapy should be considered (Goedert 2002).

• Neomycin sensitization: Neomycin may cause cutaneous sensitization. Symptoms of neomycin sensitization include itching, reddening, edema, and failure to heal. Discontinuation of product and avoidance of similar products should be considered.

• Systemic effects: Topical corticosteroids may be absorbed percutaneously. Absorption of topical corticosteroids may cause manifestations of Cushing syndrome, hyperglycemia, or glycosuria. Absorption is increased by the use of occlusive dressings, application to denuded skin, or application to large surface areas. Neomycin can induce permanent sensorineural hearing loss due to cochlear damage; risk is greater with prolonged use.

Special populations:

• Pediatric: Topical corticosteroids: Infants and small children may absorb proportionally larger amounts of corticosteroids after topical application and may be more prone to systemic effects due to larger skin surface area to body mass ratio, particularly if applying to >20% of BSA. HPA axis suppression, intracranial hypertension, and Cushing syndrome have been reported in children receiving topical corticosteroids. Prolonged use may affect growth velocity; growth should be routinely monitored in pediatric patients.

Dosage form specific issues:

• Topical ointment: Limit therapy to 7 days of treatment.

Pregnancy Risk Factor C Pregnancy Considerations

Refer to individual monographs.

Patient Education

What is this drug used for?

• It is used to treat or prevent skin infections.

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

• Dry skin

• Burning

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

• Adrenal gland problems like severe nausea, vomiting, severe dizziness, passing out, muscle weakness, severe fatigue, mood changes, lack of appetite, or weight loss

• Hearing loss

• Unable to pass urine

• Change in amount of urine passed

• Skin changes like acne, stretch marks, slow healing, or hair growth

• Application site irritation, redness, swelling, or pain

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.

Note: This is not a comprehensive list of all side effects. Talk to your doctor if you have questions.

Consumer Information Use and Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a limited summary of general information about the medicine's uses from the patient education leaflet and is not intended to be comprehensive. This limited summary does NOT include all information available about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not intended to provide medical advice, diagnosis or treatment and does not replace information you receive from the healthcare provider. For a more detailed summary of information about the risks and benefits of using this medicine, please speak with your healthcare provider and review the entire patient education leaflet.

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