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DERMATOLOGICALS › CORTICOSTEROIDS, DERMATOLOGICAL PREPARATIONS › CORTICOSTEROIDS, COMBINATIONS WITH ANTIBIOTICS › Corticosteroids, moderately potent, combinations with antibiotics
triamcinolone and antibiotics
D07CB01
Forms & Strengths
- Topical Cream: Triamcinolone acetonide 0.1% + Gramicidin 0.25% + Neomycin sulfate 0.25% + Nystatin 100,000 units/g
- Topical Ointment: Triamcinolone acetonide 0.1% + Gramicidin 0.25% + Neomycin sulfate 0.25% + Nystatin 100,000 units/g
Adult Dosing
- Apply a thin film to the affected skin area 2 to 4 times daily
- Discontinue therapy when control is achieved; if no improvement within 7 days, reassess diagnosis
Pediatric Dosing
- Apply sparingly to the affected area 2 to 4 times daily
- Limit duration of use in pediatric patients due to higher risk of systemic absorption and HPA axis suppression
Indications
- Relief of inflammatory manifestations of corticosteroid-responsive dermatoses when secondary bacterial or fungal (Candida) infection is present, suspected, or at risk
Mechanism of Action
- Triamcinolone acetonide: Intermediate-acting fluorinated corticosteroid with anti-inflammatory, antipruritic, and vasoconstrictive properties
- Neomycin and Gramicidin: Bactericidal antibiotics inhibiting bacterial protein synthesis and disrupting cell membranes
- Nystatin: Antifungal agent binding to sterols in fungal cell membranes, increasing permeability
Contraindications
- Hypersensitivity to triamcinolone, neomycin, gramicidin, nystatin, or any component of the formulation
- Viral skin infections including varicella, herpes simplex, and vaccinia
- Tuberculous and fungal skin lesions (excluding candidiasis treated by the nystatin component)
- Use in the external ear canal of patients with a perforated tympanic membrane
Adverse Reactions
- Burning, itching, irritation, dryness, folliculitis, hypertrichosis
- Hypopigmentation, perioral dermatitis, allergic contact dermatitis
- Maceration of the skin, skin atrophy, striae, miliaria
- Systemic toxicity including HPA axis suppression, Cushing's syndrome, and ototoxicity or nephrotoxicity (due to neomycin absorption)
Drug Interactions
- Concomitant systemic aminoglycosides may increase potential for nephrotoxicity and ototoxicity from neomycin
- Local administration may alter skin integrity, potentially increasing systemic absorption of other topically applied drugs
Curated Content: Needs Vetting Before Put to Clinical Use