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DERMATOLOGICALS › CORTICOSTEROIDS, DERMATOLOGICAL PREPARATIONS › CORTICOSTEROIDS, COMBINATIONS WITH ANTIBIOTICS › Corticosteroids, moderately potent, combinations with antibiotics
flumetasone and antibiotics
D07CB05
Forms & Strengths
- Otic solution: flumetasone pivalate 0.02% + clioquinol 1% + flumetasone/antibiotic combinations vary by regional preparation
- Topical cream/ointment: flumetasone pivalate 0.02% with various antibiotics (e.g., neomycin, polymyxin B)
Adult Dosing
- Otic: Instill 3 to 4 drops into the affected ear 2 to 3 times daily for 7 to 10 days
- Topical dermatologic: Apply a thin film to the affected skin area 2 to 3 times daily
Pediatric Dosing
- Otic (children > 2 years): Instill 2 to 3 drops into the affected ear 2 times daily for 7 days
- Topical dermatologic: Apply sparingly to the affected area once or twice daily; limit duration and use in pediatric populations
Indications
- Treatment of acute and chronic otitis externa complicated by bacterial infection
- Inflammatory dermatoses responsive to corticosteroids with secondary bacterial infections
Mechanism of Action
- Flumetasone pivalate is a potent topical corticosteroid with anti-inflammatory, antipruritic, and vasoconstrictive properties
- Antibiotic components (e.g., clioquinol, neomycin) provide bactericidal or bacteriostatic activity against susceptible pathogens
Contraindications
- Hypersensitivity to flumetasone, other corticosteroids, or any antibiotic component in the formulation
- Viral skin or ear infections (e.g., varicella, herpes simplex, vaccinia)
- Fungal infections of the skin or ear
- Perforated tympanic membrane (for otic preparations containing ototoxic antibiotics)
- Untreated tuberculosis or syphilis of the skin
Adverse Reactions
- Local burning, stinging, irritation, or dryness at the application site
- Secondary infections due to immunosuppression
- Skin atrophy, striae, telangiectasia, and hypopigmentation with prolonged use
- Ototoxicity (if tympanic membrane is perforated with ototoxic antibiotic combinations)
- Systemic corticosteroid absorption leading to hypothalamic-pituitary-adrenal (HPA) axis suppression with prolonged or occlusive use
Drug Interactions
- Concomitant use of other potent topical corticosteroids may increase risk of systemic toxicity
- Potential enhancement of nephrotoxicity and ototoxicity with systemic aminoglycosides if neomycin is absorbed systemically
- Possible interference with thyroid function tests if formulations contain clioquinol
Curated Content: Needs Vetting Before Put to Clinical Use