Bacitracin Neomycin Polymyxin B

Bacitracin Neomycin Polymyxin B Brand Names

Neocidin | Neo-Polycin | Neosporin | Ocu-Spore-B | Polymycin | Triple Antibiotic

What is Bacitracin Neomycin Polymyxin B

Bacitracin Neomycin Polymyxin B are used together in ophthalmic and topical preparations.

The ophthalmic preparations are indicated for the treatment of ocular bacterial infections such as conjunctivitis, keratitis, keratoconjunctivitis, blepharitis, and blepharoconjunctivitis.

The topical preparations are used to prevent superficial skin infections on minor cuts, abrasions, and burn wounds. Bacitracin is a mixture of cyclic polypeptides produced by Bacillus subtilis. Neomycin is an aminoglycoside antibiotic derived from cultures of Streptomyces fradiae.

Polymyxin B is a polypeptide antibiotic derived from a strain of Bacillus polymyxa. The combine use of bacitracin, neomycin, and polymyxin B provides a wide antibacterial spectrum.

Neomycin and polymyxin B are primarily active against gram-negative, aerobic bacteria, while bacitracin is effective against gram-positive bacteria.

The FDA approved bacitracin, neomycin, and polymyxin B ophthalmic preparations prior to 1982 and the first topical product in November 1987.

Indications

  1. bacterial conjunctivitis
  2. blepharitis
  3. blepharoconjunctivitis
  4. burn wound infection
  5. Enterobacter sp.
  6. Escherichia coli
  7. Haemophilus influenzae (beta-lactamase negative)
  8. Haemophilus influenzae (beta-lactamase positive)
  9. keratitis
  10. keratoconjunctivitis
  11. Klebsiella sp.
  12. Neisseria sp.
  13. ophthalmic infection
  14. Pseudomonas aeruginosa
  15. skin abrasion
  16. skin and skin structure infections
  17. Staphylococcus aureus (MSSA)
  18. Streptococcus pneumoniae
  19. Streptococcus sp.
  20. wound management

Side Effects

  1. anaphylactoid reactions
  2. edema
  3. erythema
  4. hearing loss
  5. ocular pruritus
  6. pruritus
  7. superinfection

Monitoring Parameters

  • ophthalmologic exam

Contraindications

  • aminoglycoside hypersensitivity
  • breast-feeding
  • children
  • contact lenses
  • diarrhea
  • fungal infection
  • geriatric
  • hearing impairment
  • herpes infection
  • infants
  • mycobacterial infection
  • neomycin hypersensitivity
  • neonates
  • ophthalmic administration
  • polymyxin hypersensitivity
  • pregnancy
  • pseudomembranous colitis
  • renal failure
  • renal impairment
  • tuberculosis
  • varicella
  • viral infection

Interactions

  • Amphotericin B
  • Amphotericin B cholesteryl sulfate complex (ABCD)
  • Amphotericin B lipid complex (ABLC)
  • Amphotericin B liposomal (LAmB)
  • Bumetanide
  • Ethacrynic Acid
  • Furosemide
  • Loop diuretics
  • Torsemide