Neomycin + bacitracin


Full Prescribing Info
Dosage/Direction for Use

Topical/Cutaneous
Bacterial skin infections
Adult: As cream containing 3300 units/g of neomycin and 250 units/g of bacitracin zinc: Apply a thin layer up to 3 times daily. As powder containing 5000 units/g of neomycin and 250 units/g of bacitracin zinc: Apply 2-4 times daily.
Contraindications
Hypersensitivity to aminoglycosides. Pre-existing nerve deafness. Neonates and infants <2 yr.
Special Precautions
Neuromuscular disorders, hearing impaired, extensive skin damage. Avoid application in large quantities and prolonged use. Do not use if tympanic membrane is perforated. Pregnancy and lactation. Liver and renal impairment.
Adverse Reactions
Hypersensitivity reactions. Possibility of ototoxicity and nephrotoxicity if used in large quantities or on large areas for prolonged use.
Overdosage
Symptoms: Nephrotoxicity and ototoxicity may occur if significant amounts are absorbed systemically. Management: Discontinue the product and monitor patient's hearing acuity, renal, neuromuscular function and serum concentrations of neomycin and bacitracin. Haemodialysis may be useful in reducing neomycin levels.
Drug Interactions
Additive toxicity with neurotoxic, ototoxic or nephrotoxic drugs. Increased neuromuscular blockade and possibly respiratory depression with neuromuscular blocking agents if significant amount of neomycin is absorbed systemically.
Action
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, on the other hand, 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.
Absorption: Neomycin: Poorly absorbed from GI tract. Absorption may occur from peritoneum, respiratory tract, bladder, wounds and inflamed skin; increased when mucosa is damaged or inflamed. Bacitracin: Poorly absorbed from the GI tract or from intact or denuded skin, wounds or mucous membranes.
Distribution: Bacitracin: Diffuses into pleural and ascitic fluids.
Excretion: Neomycin: 97% of oral dose excreted unchanged in faeces; absorbed neomycin excreted by kidneys in active form; half life: 2-3 hr. Bacitracin: 10-40% of injected dose excreted slowly by kidney and appears in urine within 24 hr.
CIMS Class
ATC Classification
A01AB08 - neomycin ; Belongs to the class of local antiinfective and antiseptic preparations. Used in the treatment of diseases of the mouth.
S03AA01 - neomycin ; Belongs to the class of antiinfectives used in ophthalmologic and otologic preparations.
R02AB01 - neomycin ; Belongs to the class of antibiotics used in throat preparations.
R02AB04 - bacitracin ; Belongs to the class of antibiotics used in throat preparations.
J01GB05 - neomycin ; Belongs to the class of other aminoglycosides. Used in the systemic treatment of infections.
A07AA01 - neomycin ; Belongs to the class of antibiotics. Used in the treatment of intestinal infections.
D06AX04 - neomycin ; Belongs to the class of other topical antibiotics used in the treatment of dermatological diseases.
B05CA09 - neomycin ; Belongs to the class of antiinfectives used as irrigating solutions.
J01XX10 - bacitracin ; Belongs to the class of other antibacterials. Used in the systemic treatment of infections.
S02AA07 - neomycin ; Belongs to the class of antiinfectives used in the treatment of ear infections.
S01AA03 - neomycin ; Belongs to the class of antibiotics. Used in the treatment of eye infections.
D06AX05 - bacitracin ; Belongs to the class of other topical antibiotics used in the treatment of dermatological diseases.
Disclaimer: This information is independently developed by CIMS based on neomycin + bacitracin from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to CIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, CIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 CIMS. All rights reserved. Powered by CIMSAsia.com
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