Neomycin

Neomycin Brand Name– Neo Fradin

What is Neomycin

Neomycin is an aminoglycoside antibiotic. It is derived from cultures of Streptomyces fradiae.

Although bioavailability after oral administration is poor, neomycin is administered orally in patients with hepatic coma or portal-systemic encephalopathy. Oral neomycin also has a lipid-lowering effect but is infrequently used for this purpose.

Neomycin is most often used topically as an antiinfective.

Parenteral neomycin is no longer used due to severe ototoxicity, and administration of neomycin as a surgical irrigant is no longer recommended.

Neomycin is not indicated for the treatment of systemic infections because it can cause irreversible ototoxicity.

Neomycin was approved by the FDA in 1952.

Indications

  1. Acinetobacter sp.
  2. Bacillus anthracis
  3. bowel preparation
  4. Citrobacter sp.
  5. Enterobacter sp.
  6. Escherichia coli
  7. Haemophilus influenzae (beta-lactamase negative)
  8. Haemophilus influenzae (beta-lactamase positive)
  9. hepatic encephalopathy
  10. infectious diarrhea
  11. Klebsiella sp.
  12. Neisseria sp.
  13. Proteus mirabilis
  14. Proteus vulgaris
  15. Providencia sp.
  16. Salmonella sp.
  17. Serratia sp.
  18. Shigella sp.
  19. skin and skin structure infections
  20. Staphylococcus aureus (MSSA)
  21. Staphylococcus epidermidis

Side Effects

  1. azotemia
  2. cylindruria
  3. diarrhea
  4. folate deficiency
  5. hearing loss
  6. hyposthenuria
  7. iron deficiency
  8. maculopapular rash
  9. myasthenia
  10. nausea
  11. nephrotoxicity
  12. neurotoxicity
  13. ototoxicity
  14. proteinuria
  15. pruritus
  16. pyuria
  17. renal tubular acidosis (RTA)
  18. renal tubular necrosis
  19. seizures
  20. steatorrhea
  21. superinfection
  22. tinnitus
  23. urticaria
  24. vertigo
  25. vitamin B12 deficiency
  26. vitamin B6 deficiency
  27. vitamin D deficiency
  28. vomiting

Monitoring Parameters

  • audiometry
  • serum creatinine/BUN

Contraindications

  • aminoglycoside hypersensitivity
  • botulism
  • breast-feeding
  • colitis
  • dehydration
  • diarrhea
  • geriatric
  • GI disease
  • GI obstruction
  • hearing impairment
  • ileus
  • inflammatory bowel disease
  • myasthenia gravis
  • neonates
  • nephrotoxicity
  • neuromuscular blockade
  • neuromuscular disease
  • neurotoxicity
  • ototoxicity
  • parkinsonism
  • pregnancy
  • pseudomembranous colitis
  • renal disease
  • renal impairment
  • respiratory depression
  • respiratory insufficiency
  • ulcerative colitis

Interactions

  • Alpha-glucosidase Inhibitors
  • Amphotericin B
  • Amphotericin B cholesteryl sulfate complex (ABCD)
  • Amphotericin B lipid complex (ABLC)
  • Amphotericin B liposomal (LAmB)
  • Bacitracin
  • Beractant
  • Botulinum Toxins
  • Calfactant
  • Cisplatin
  • Clofarabine
  • Colfosceril; Cetyl Alcohol; Tyloxapol
  • Cyanocobalamin, Vitamin B12
  • Cyclosporine
  • Dienogest; Estradiol valerate
  • Digoxin
  • Enflurane
  • Estradiol
  • Estradiol Cypionate; Medroxyprogesterone
  • Fluorouracil, 5-FU
  • Lactulose
  • Methotrexate
  • Nonsteroidal antiinflammatory drugs
  • Oral Contraceptives
  • Penicillin V
  • Poractant Alfa
  • Regorafenib
  • Sorafenib
  • Surfactants
  • Warfarin
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