Neomycin and polymyxin B combination is often used in:
otitis externa i.e. external ear infections,
infected dermatoses to prevent bacterial infections.
Neomycin, a topical aminoglycoside is bactericidal in nature. This drug exerts its action by binding to the bacterial ribosomes resulting in inhibition of protein synthesis and thereby disrupting DNA synthesis. It is active against many gram-negative aerobes and some strains of staphylococci.
Another antibiotic used in this preparation is Polymyxin B, which is a low molecular weight cationic polypeptide antibiotic. It disrupts bacterial cell membrane and has bactericidal action against most gram-negative bacilli.
This product is available without a prescription.
You can get this medicine in two forms: cream and powder.
2 What to know before using
If you are about to start a drug therapy, the risk-benefit ratio of taking the drug should be considered carefully. The most suitable drug therapy is chosen by a doctor with active participation of the patient.
There are some important factors such as:
presence of any metabolic impairment,
history of hypersensitivity reaction,
lactation etc. that may alter the desired therapeutic effects of a medicine.
Sometimes the presence of other health disorders affects the beneficial effects of this medicine and even may cause serious toxic effects.
Make sure you mention your doctor if you have any other medical problems because the use of this medicine is contraindicated in certain medical conditions such as:
hypersensitivity to aminoglycosides and any of its components,
Further, certain medicines should not be used along with this combination medicine.
It is always recommended to consult with your doctor if you are in need of some other medications or even any over-the-counter medicine for another health problem in order to avoid unwanted toxic effects. In addition, you should have the knowledge of following drug interactions before you start receiving this medicine:
Additive toxicity of this medicine with neurotoxic, ototoxic or nephrotoxic drugs.
Increased neuromuscular blockade and possibly respiratory depression with neuromuscular blocking agents if significant amount of neomycin absorbed.
Studies over animal have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of this medicine in pregnant women despite potential risks.
You should use this medicine following the directions given by your doctor. The dosage schedule and the duration of drug therapy depend on the particular medical problem for which you are going to use this medicine. The therapeutic dose may also vary with the patient’s condition or requirement and the strength of the medicine as well.
You should not miss any doses. If you miss a dose of this medicine, you should apply it as soon as possible. But, if it is almost time for the next dose, it is advised to go back to the regular dosing schedule skipping the missed dose.
In order to prevent minor bacterial infections:
Adults and children of ≥2 years of age are prescribed to apply this medicine to the affected area 1 to 3 times a day.
The use and dose for the children of less than 2 years should be determined by a pediatrician.
Before applying the medicine, you should wash the affected area with soap and water, and dry thoroughly. Then, apply a small amount of this medicine to the affected area and rub gently.
Further, it is advised to store the medicine in a closed container at room temperature away from heat, moisture, and direct light. All kinds of medicines should be kept out of the reach of children. However, outdated medicines should be disposed by an appropriate way.
4 Precautions to take
Firstly, regular visits to your doctor are recommended to check the prognosis while undergoing any drug therapy. If the symptoms do not improve within 7 days or get worse, you should not delay to check with your doctor.
Additionally, the following guidelines should be followed:
Avoid using this medicine during pregnancy because of risk of fetal ototoxicity.
Avoid concurrent use of nephrotoxic drugs such as NSAIDs, amphotericin B, cyclosporine, and cisplatin.
Cautious use of muscle relaxants and other potentially ototoxic drugs like vancomycin, minocycline, and furosemide, though clinical evidence of potentiated ototoxicity is meager.
Cautious use in patients of more than 60 years of age and in those with kidney damage.
However, you should keep using this medicine for the full time of treatment to clear up your skin infection completely, even if your symptoms have disappeared.
5 Potential side effects
There are some unwanted side effects associated with each drug that usually do not need medical attention. These side effects usually go away during the treatment episode as your body adjusts to the medicine. Your healthcare professional may advise you about the ways how to prevent or reduce those unwanted side effects.
Sometimes you may need to consult with the doctor if you notice any of the following toxic effects, especially:
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