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SENSORY ORGANS › OPHTHALMOLOGICAL AND OTOLOGICAL PREPARATIONS › CORTICOSTEROIDS AND ANTIINFECTIVES IN COMBINATION › Corticosteroids and antiinfectives in combination
dexamethasone and antiinfectives
S03CA01
Forms & Strengths
- Ophthalmic suspension: dexamethasone 0.1% combined with anti-infectives (e.g., neomycin, polymyxin B, or ciprofloxacin)
- Ophthalmic ointment: dexamethasone combined with anti-infectives
Adult Dosing
- Ophthalmic suspension: Instill 1 to 2 drops into the conjunctival sac(s) every 4 to 6 hours
- Severe infections: Instill 1 to 2 drops hourly until control is achieved, then taper dosage
- Ophthalmic ointment: Apply a small amount (approx. 0.5 inch ribbon) into the conjunctival sac(s) up to 3 to 4 times daily
Pediatric Dosing
- Safety and efficacy in pediatric patients below a certain age (often <2 years or varying by specific combination) are not well established
- Use lowest effective dose and limit duration of therapy to minimize systemic corticosteroid absorption
Indications
- Steroid-responsive inflammatory ocular conditions where a corticosteroid is indicated and there is a superficial bacterial ocular infection or a risk of bacterial infection
- Inflammation of the palpebral and bulbar conjunctiva, cornea, and anterior segment of the globe
Mechanism of Action
- Dexamethasone: Potent synthetic corticosteroid that suppresses the inflammatory response to a variety of agents, inhibiting edema, fibrin deposition, capillary dilation, leukocyte migration, capillary proliferation, fibroblast proliferation, and scar formation
- Anti-infective component(s): Broad-spectrum bactericidal or bacteriostatic antibiotics eradicate susceptible bacterial pathogens causing or risking superinfection
Contraindications
- Epithelial herpes simplex keratitis (dendritic keratitis)
- Vaccinia, varicella, and other viral diseases of the cornea and conjunctiva
- Mycobacterial infection of the eye
- Fungal diseases of ocular structures
- Hypersensitivity to 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 and bacterial) due to immunosuppression
- Temporary stinging, burning, or blurred vision upon instillation
Drug Interactions
- Concomitant use of topical anticholinergics may increase intraocular pressure
- Prolonged use with local anesthetics may cause permanent corneal damage
- Potential for additive nephrotoxicity or ototoxicity if aminoglycoside components are absorbed systemically alongside other systemic aminoglycosides
Curated Content: Needs Vetting Before Put to Clinical Use