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SENSORY ORGANS › OPHTHALMOLOGICALS › ANTIINFECTIVES › Antibiotics
antibiotics in combination with other drugs
S01AA20
Forms & Strengths
- Ophthalmic ointment: Polymyxin B sulfate 10,000 units, Neomycin sulfate 3.5 mg, Bacitracin zinc 400 units per gram
- Ophthalmic solution: Polymyxin B sulfate 10,000 units, Neomycin sulfate 1.75 mg, Gramicidin 0.025 mg per mL
- Ophthalmic ointment: Oxytetracycline hydrochloride 5 mg, Polymyxin B sulfate 10,000 units per gram
Adult Dosing
- Ophthalmic solution: Instill 1 to 2 drops in the affected eye(s) every 3 to 4 hours, depending on severity.
- Ophthalmic ointment: Apply a thin ribbon (approx. 0.5 inch) into the conjunctival sac(s) 3 to 4 times daily.
Pediatric Dosing
- Ophthalmic solution (infants and children): Instill 1 to 2 drops into affected eye(s) 3 to 4 times daily or every 3 hours.
- Ophthalmic ointment (infants and children): Apply a small amount (0.5 inch ribbon) into conjunctival sac(s) 3 to 4 times daily.
Indications
- Treatment of superficial ocular infections involving the conjunctiva and/or cornea caused susceptible organisms
- Prophylaxis of ocular infections following trauma, foreign body removal, or chemical/physical burns
Mechanism of Action
- Polymyxin B binds to bacterial cell membrane phospholipids, altering permeability and causing intracellular leakage.
- Neomycin and Gramicidin inhibit bacterial protein synthesis by binding to the 30S ribosomal subunit.
- Bacitracin interferes with bacterial cell wall synthesis by inhibiting lipid pyrophosphate dephosphorylation.
Contraindications
- Hypersensitivity to any of the active ingredients (neomycin, polymyxin B, bacitracin, gramicidin, tetracyclines) or excipients
- Epithelial herpes simplex keratitis (dendritic keratitis)
- Vaccinia, varicella, and other viral diseases of the cornea and conjunctiva
- Mycobacterial or fungal infections of the eye
Adverse Reactions
- Transient stinging or burning upon instillation
- Allergic hypersensitivity reactions including contact dermatitis, pruritus, and eyelid edema
- Superinfection with non-susceptible organisms or fungi with prolonged use
Drug Interactions
- Concomitant use of other topical ophthalmic aminoglycosides may potentiate systemic or ocular toxicity.
- Prolonged concurrent topical corticosteroid use may mask hypersensitivity reactions or exacerbate fungal/viral infections.
Curated Content: Needs Vetting Before Put to Clinical Use