Generic
Hydrocortisone + Neomycin Sulphate + Polymixin B
2 brands available in the market
At a glance
Hydrocortisone + Neomycin Sulphate + Polymixin B ear drops are used for the treatment of bacterial ear infections.
Description
Hydrocortisone + Neomycin Sulphate + Polymixin B ear drops are used for the treatment of bacterial ear infections. Polymyxin B sulphate and neomycin sulphate are antibiotics that kill the germs that can cause ear infections. Hydrocortisone is a steroid that helps reduce the swelling and irritation caused by the infection. This combination is active against Staphylococcus aureus, Escherichia coli, Haemophilus influenzae, Klebsiella-Enterobacter species, Neisseria species, and Pseudomonas aeruginosa.
Indications
- Bacterial ear infections (Otitis externa)
- Ocular inflammation with suspected or confirmed bacterial infection
Therapeutic class
Ophthalmic steroid - antibiotic combined preparations, Ophthalmic Steroid preparations
Pharmacological class
Corticosteroid + Aminoglycoside + Polymixin Antibiotic
Pharmacology
Neomycin, an aminoglycoside with spectrum similar to gentamicin, binds to the 30S subunits of the bacterial ribosome, inhibiting protein synthesis and thereby disrupting DNA synthesis. Polymyxin B disrupts bacterial cell membrane and has bactericidal action against most Gram-negative bacilli. Hydrocortisone, a corticosteroid with mainly glucocorticoid activity, suppresses inflammatory response.
Mechanism of action
Neomycin kills bacteria by inhibiting protein synthesis; Polymyxin B disrupts bacterial cell membrane; Hydrocortisone reduces inflammation and swelling.
Dosage
Adult Dose (Otic/Aural):
- Neomycin sulfate 3.5 mg (as neomycin base), polymyxin B sulfate 10,000 units, hydrocortisone 10 mg (1%) per ml: Instill 4 drops into affected ear 3-4 times daily
- Instill drop with the affected ear upward and remain in this position for 5 minutes
- Alternatively use a cotton wick
Child Dose (2-16 years):
- Instill 3 drops into affected ear 3-4 times daily
Ophthalmic Dose:
- 1-2 drops every 3-4 hours
Administration
Shake the closed bottle gently before each use; clean and dry the ears; do not use soap; do not put drops in eyes; finish the prescribed course.
Missed dose
If you miss a dose, apply it as soon as possible; if it is almost time for your next dose, skip the missed dose.
Side effects
Rare Side Effects:
- Worsening of infection
- Redness, scaly and itchy
Ophthalmic: Irritation, increased intraocular pressure, glaucoma, posterior subcapsular cataract formation, delayed wound healing, secondary infections
Precautions & warnings
Precautions:
- Caution in kidney problems
- Caution in long-standing infection of outer ear
- Ophthalmic: Monitor intraocular pressure if used for >10 days
- Otic: Limit use to ≤10 days to reduce risk of ototoxicity
Contraindications
Contraindications:
- Allergy to polymyxin B sulphate, neomycin sulphate, hydrocortisone or any other ingredients
- Allergy to aminoglycoside antibiotics (framycetin, kanamycin, gentamicin)
- Perforated ear drum
- Viral, fungal or tubercular (TB) infection
- Children under 3 years old
Drug interactions
Drug Interactions:
- Additive toxicity with neurotoxic, ototoxic or nephrotoxic drugs
- Increased neuromuscular blockade and possibly respiratory depression with neuromuscular blocking agents if significant amounts of neomycin absorbed significantly
Food interactions
No food interaction found/established.
Use in pregnancy
Use in Pregnancy: Do not use if pregnant or planning pregnancy; consult your doctor.
Use in lactation
Use in Lactation: Do not breast-feed while using this; consult your doctor.
Pediatric use
Contraindicated in children under 3 years; dose provided for 2-16 years.
Geriatric use
No specific data for elderly.
Renal / hepatic impairment
Caution in kidney problems.
Overdose effects
No information on overdose; do not exceed the recommended dose.
Storage conditions
Do not store above 25°C; store in the carton to protect from light; keep out of reach and sight of children.
Chemical structure
Hydrocortisone + Neomycin Sulphate + Polymixin B