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SENSORY ORGANS › OPHTHALMOLOGICALS › ANTIINFLAMMATORY AGENTS AND ANTIINFECTIVES IN COMBINATION › Corticosteroids and antiinfectives in combination
hydrocortisone and antiinfectives
S01CA03
Forms & Strengths
- Ophthalmic suspension: Hydrocortisone acetate 1.5% + antiinfective (e.g., neomycin, polymyxin B)
- Ophthalmic ointment: Hydrocortisone acetate 1.5% + antiinfective
Adult Dosing
- Suspension: Instill 1 to 2 drops into the affected conjunctival sac(s) up to 4 to 6 times daily
- Ointment: Apply a small amount (approx. 0.5 inch ribbon) into the conjunctival sac(s) up to 3 to 4 times daily
- Taper dose upon clinical improvement; do not abruptly discontinue in chronic conditions
Pediatric Dosing
- Safety and efficacy in pediatric patients below the age of 2 years have not been established
- Dosage in children 2 years and older mirrors adult dosing, utilizing the lowest effective concentration
Indications
- Steroid-responsive inflammatory ocular conditions where bacterial infection or a risk of bacterial infection exists
- Inflammatory conditions of the palpal and bulbar conjunctiva, cornea, and anterior segment of the globe where risk of infection warrants combined therapy
Mechanism of Action
- Hydrocortisone: Suppresses the inflammatory response, migration of polymorphonuclear leukocytes, fibroblast proliferation, and immune response in ocular tissues
- Antiinfective component(s) (e.g., aminoglycosides, polymyxin): Bind to bacterial ribosomal subunits or disrupt cell membranes to inhibit protein synthesis and cause bacterial cell death
Contraindications
- Most viral diseases of the cornea and conjunctiva including epithelial herpes simplex keratitis (dendritic keratitis), vaccinia, and varicella
- Mycobacterial infection of the eye
- Fungal diseases of ocular structures
- Hypersensitivity to hydrocortisone or any component of the formulation
Adverse Reactions
- Elevated intraocular pressure with possible development of glaucoma
- Posterior subcapsular cataract formation
- Delayed wound healing
- Secondary ocular infection (fungal or viral proliferation)
- Transient stinging or burning upon instillation
Drug Interactions
- Concomitant use of topical anticholinergics may increase intraocular pressure
- Prolonged systemic absorption of aminoglycosides can enhance toxicity of other neurotoxic, ototoxic, or nephrotoxic agents
Curated Content: Needs Vetting Before Put to Clinical Use