Antibiotic Otic

1 What is Antibiotic Otic?

Brand: Antibiotic Otic, Cort-Biotic, Cortisporin, Cortomycin, Oti-Sone, Pediotic

Generic: Neomycin, Polymyxin B, And Hydrocortisone

Neomycin, polymyxin B, and hydrocortisone is a combination antibiotic and cortisone-like medicine. This is often used to treat infections of the ear canal as well as to provide relief from redness, irritation, and also discomfort of certain ear problems.
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. A topical steroid, hydrocortisone is also used in this preparation which suppresses inflammatory response.

Neomycin, polymyxin B, and hydrocortisone preparation is available only with doctor's prescription. This product is available in solution and suspension forms.

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:

  • drug interactions,
  • presence of any metabolic impairment,
  • history of hypersensitivity reaction,
  • pregnancy,
  • 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,
  • pre-existing nerve deafness,
  • tuberculosis,
  • fungal or viral infections.

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.

3 Proper usage

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. 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.

  • For ear canal infection, an adult is usually advised to use 4 drops in the ear 3 to 4 times a day, whereas, use of 3 drops is recommended in children.
  • For mastoid cavity infection, 4 to 10 drops can be used in the ear 6 to 8 hourly. In case of children, 4 or 5 drops can be given in the ear every 6 to 8 hours.

Before using the medicine, you may warm this medicine to body temperature (37 °C or 98.6 °F) by holding the bottle in your hand for a few minutes. You should lie down or tilt your head so that the infected ear faces up. It is easy to drop the medicine into the ear canal by pulling the earlobe up and back gently to straighten the ear canal. Finally, you must keep your ear facing up for about 5 minutes to allow the medicine to coat the ear canal.

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.
  • Besides, this medicine should not be used for more than 10 days unless otherwise prescribed by your doctor.

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:

  • Burning pain
  • Dermal atrophy
  • Fever
  • Folliculitis
  • Headache
  • Hypersensitivity
  • Itching
  • Irritation
  • Local irritation
  • Secondary infection
  • Nephrotoxicity
  • Neuromuscular blockade
  • Ototoxicity when instilled in patients with perforated eardrum

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