MedPath

Neomycin

Generic Name
Neomycin
Brand Names
Casporyn HC, Cortisporin, Cortisporin-TC, Dioptrol, Diosporin, Diphen, Maxitrol, Neo-polycin, Neo-polycin HC, Neo-synalar, Neosporin Ointment, Neosporin Plus Maximum Strength, Neosporin Plus Maximum Strength Cream, Neosporin Solution, Procomycin, Statrol, Triple Antibiotic, Viaderm Kc
Drug Type
Small Molecule
CAS Number
1404-04-2
Unique Ingredient Identifier
I16QD7X297

Overview

Neomycin is a broad-spectrum aminoglycoside antibiotic drug that is derived from the metabolic products of Streptomyces fradiae. Neomycin is a complex comprised of three components, neomycin A, B, and C. Neomycin B, also known as framycetin, is the most active component of the complex and neomycin C is the isomer of neomycin B, making these two stereoisomers the active components of neomycin. Neomycin A, or neamine, is a moiety that conjoins two molecules of neomycin B and C together. Neomycin is active against both gram-positive and gram-negative organisms and mediates its pharmacological action by binding to bacterial ribosomes and inhibiting protein synthesis, which is crucial for the survival of bacteria. Neomycin sulfate is the most common form for pharmaceutical preparations; because the compound is a complex, the amount of neomycin in products is measured in units. Neomycin sulfate as monotherapy is available in an oral solution for adjunct use in the treatment of hepatic coma. It is also used in combination with polymyxin B sulfates and hydrocortisone in otic suspensions for use in the treatment of bacterial infections in the external auditory canal, including infections caused by medical procedures in the ear. Neomycin is also used in combination with polymyxin B sulfates and dexamethasone in ophthalmic preparations for use in the treatment of inflammatory conditions and infections in the eye. Neomycin is also available in over-the-counter topical products to prevent minor skin infections.

Background

Neomycin is a broad-spectrum aminoglycoside antibiotic drug that is derived from the metabolic products of Streptomyces fradiae. Neomycin is a complex comprised of three components, neomycin A, B, and C. Neomycin B, also known as framycetin, is the most active component of the complex and neomycin C is the isomer of neomycin B, making these two stereoisomers the active components of neomycin. Neomycin A, or neamine, is a moiety that conjoins two molecules of neomycin B and C together. Neomycin is active against both gram-positive and gram-negative organisms and mediates its pharmacological action by binding to bacterial ribosomes and inhibiting protein synthesis, which is crucial for the survival of bacteria. Neomycin sulfate is the most common form for pharmaceutical preparations; because the compound is a complex, the amount of neomycin in products is measured in units. Neomycin sulfate as monotherapy is available in an oral solution for adjunct use in the treatment of hepatic coma. It is also used in combination with polymyxin B sulfates and hydrocortisone in otic suspensions for use in the treatment of bacterial infections in the external auditory canal, including infections caused by medical procedures in the ear. Neomycin is also used in combination with polymyxin B sulfates and dexamethasone in ophthalmic preparations for use in the treatment of inflammatory conditions and infections in the eye. Neomycin is also available in over-the-counter topical products to prevent minor skin infections.

Indication

Oral neomycin sulfate is indicated as an adjunctive therapy in hepatic coma (portal-system encephalopathy) by reducing ammonia-forming bacteria in the intestinal tract. It is strongly recommended that oral neomycin is only used in infections that are proven or strongly suspected to be caused by susceptible bacteria to reduce the risk of the development of drug-resistant bacteria. Neomycin, in combination with polymyxin B sulfates and hydrocortisone in otic suspensions, is used in the treatment of superficial bacterial infections of the external auditory canal caused by organisms susceptible to the antibiotics. This otic formulation is also used in the treatment of infections of mastoidectomy and fenestration cavities caused by organisms susceptible to the antibiotics. The ophthalmic solution containing neomycin in combination with polymyxin B sulfates and dexamethasone is used to treat steroid-responsive inflammatory ocular conditions for which a corticosteroid is indicated and where bacterial infection or a risk of bacterial infection exists.

Associated Conditions

  • Allergic Contact Dermatitis
  • Allergic Skin Reaction
  • Atopic Dermatitis
  • Atopic Dermatitis (AD) of the external ear canal
  • Bacterial diarrhoea
  • Burns
  • Carbuncle
  • Contact Dermatitis
  • Cradle Cap
  • Dermatitis
  • Diarrhea
  • Discoid Lupus Erythematosus (DLE)
  • Ear infection bacterial
  • Ear infection bacterial caused by susceptible bacteria
  • Gastrointestinal Tract Infections
  • Hepatic coma
  • Hidradenitis Suppurativa (HS)
  • Hot Water Burns (Scalds)
  • Impetigo
  • Impetigo contagious
  • Infantile Eczema
  • Infected skin ulcer
  • Infection of the outer ear caused by susceptible bacteria
  • Infectious diarrhea
  • Inflammatory Reaction caused by Acne
  • Intertrigo
  • Itching caused by Infection
  • Lichen Planus (LP)
  • Localized Infection caused by susceptible bacteria
  • Nail infection
  • Neurodermatitis
  • Otitis Externa
  • Postoperative Wound Infection
  • Psoriasis Vulgaris (Plaque Psoriasis)
  • Pustular Dermatosis
  • Pustular acne
  • Radiodermatitis
  • Secondarily Infected Eczema
  • Secondary Bacterial Infection
  • Skin Burn
  • Skin Infections
  • Skin Irritation
  • Skin Ulcer
  • Solar erythema
  • Wound Infections
  • Abrasions
  • Bacterial skin infections
  • Blistering caused by Staphylococcus
  • Erythematous eruptions
  • Intertriginous erythema of the anogenital
  • Ocular bacterial infections caused by susceptible bacteria
  • Resistant to other corticosteroids Dermatosis
  • Susceptible Bacterial Infections

FDA Approved Products

NEOMYCIN AND POLYMYXIN B SULFATES AND DEXAMETHASONE
Manufacturer:Advanced Rx Pharmacy of Tennessee, LLC
Route:OPHTHALMIC
Strength:3.5 mg in 1 g
Approved: 2023/01/11
NDC:80425-0229
Neomycin and Polymyxin B Sulfates and Hydrocortisone
Manufacturer:Bryant Ranch Prepack
Route:AURICULAR (OTIC)
Strength:3.5 mg in 1 mL
Approved: 2021/09/15
NDC:63629-8844
NEOMYCIN AND POLYMYXIN B SULFATES AND HYDROCORTISONE
Manufacturer:STAT RX USA LLC
Route:OPHTHALMIC
Strength:3.5 mg in 1 mL
Approved: 2010/06/09
NDC:16590-347
NEOMYCIN SULFATE, POLYMYXIN B SULFATE AND DEXAMETHASONE
Manufacturer:STAT RX LLC USA
Route:OPHTHALMIC
Strength:3.5 mg in 1 mL
Approved: 2010/06/09
NDC:16590-167
Neomycin and Polymyxin B Sulfates and Hydrocortisone
Manufacturer:A-S Medication Solutions
Route:AURICULAR (OTIC)
Strength:3.5 mg in 1 mL
Approved: 2016/08/31
NDC:50090-0431

Singapore Approved Products

NEO-BETASONE CREAM
Manufacturer:HOVID BHD
Form:CREAM
Strength:0.5% w/w
Online:Yes
Approved: 1990/03/28
Approval:SIN04129P
NEO-CORTISONE CREAM
Manufacturer:HOVID BHD
Form:CREAM
Strength:500 mg/100 g
Online:Yes
Approved: 1990/03/28
Approval:SIN04113P
PROCTOSEDYL SUPPOSITORY
Manufacturer:HANDOK PHARMACEUTICALS CO LTD, PT Aventis Pharma
Form:SUPPOSITORY
Strength:10 mg
Online:Yes
Approved: 1988/06/08
Approval:SIN01717P
UNIFLEX-N CREAM
Manufacturer:XEPA-SOUL PATTINSON (MALAYSIA) SDN BHD
Form:CREAM
Strength:0.5% w/w
Online:Yes
Approved: 1988/06/23
Approval:SIN01930P
MAXITROL STERILE OPHTHALMIC SUSPENSION
Manufacturer:ALCON-COUVREUR NV
Form:SOLUTION
Strength:3500 iu/ml
Online:Yes
Approved: 1990/05/02
Approval:SIN04358P

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