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DERMATOLOGICALS › CORTICOSTEROIDS, DERMATOLOGICAL PREPARATIONS › CORTICOSTEROIDS, COMBINATIONS WITH ANTIBIOTICS › Corticosteroids, very potent, combinations with antibiotics
clobetasol and antibiotics
D07CD01
Forms & Strengths
- Topical cream containing clobetasol propionate and neomycin/polymyxin B (or similar antibiotic combinations depending on regional availability)
- Topical ointment containing high-potency corticosteroid and broad-spectrum antibiotics
- Topical lotion formulations combining ultra-high potency steroid with anti-infective agents
Adult Dosing
- Apply a thin film to the affected skin area 1 to 2 times daily
- Limit treatment duration to no more than 2 consecutive weeks due to corticosteroid potency
- Maximum weekly application should not exceed 50 grams to prevent systemic absorption and HPA axis suppression
Pediatric Dosing
- Safety and efficacy in pediatric patients under 12 years are not established
- Avoid use in diaper dermatitis
- If use is required in older children, limit to the smallest effective amount for the shortest possible duration under close supervision
Indications
- Short-term treatment of severe inflammatory dermatoses where secondary bacterial infection is present, suspected, or at high risk
- Eczema, resistant plaque psoriasis, or lichen simplex chronicus with superimposed bacterial colonization
Mechanism of Action
- Clobetasol propionate: Ultra-high potency topical corticosteroid with anti-inflammatory, antipruritic, and vasoconstrictive properties via induction of phospholipase A2 inhibitory proteins (lipocortins)
- Antibiotic component: Inhibits bacterial protein synthesis or disrupts cell wall synthesis to eradicate susceptible cutaneous pathogens (e.g., Staphylococcus aureus, Streptococcus species)
Contraindications
- Hypersensitivity to clobetasol, other corticosteroids, or any constituent antibiotics in the formulation
- Viral skin infections (e.g., varicella, herpes simplex, vaccinia)
- Fungal skin infections
- Tuberculosis or syphilis of the skin
- Rosacea and perioral dermatitis
Adverse Reactions
- Local burning, stinging, irritation, dryness, and folliculitis
- Skin atrophy, striae, telangiectasia, and purpura with prolonged use
- Hypopigmentation or hyperpigmentation
- Systemic absorption leading to hypothalamic-pituitary-adrenal (HPA) axis suppression, Cushing's syndrome, and hyperglycemia
- Secondary opportunistic fungal or bacterial infections due to immunosuppression and antibiotic resistance
Drug Interactions
- Concomitant use of other potent topical corticosteroids may increase the risk of systemic toxicity
- Systemic cytochrome P450 3A4 inhibitors (e.g., ritonavir, itraconazole) may potentially increase systemic exposure of the corticosteroid component
- Potential additive nephrotoxicity or ototoxicity if aminoglycoside antibiotics are absorbed systemically in patients taking other ototoxic/nephrotoxic drugs
Curated Content: Needs Vetting Before Put to Clinical Use