Adult Dosing

Minor cuts, scrapes, burns

• Apply a small amount on the affected area qd-tid

Note:

• Affected area may be covered with a bandage after application

Pediatric Dosing

Minor cuts, scrapes, burns

• Apply a small amount on the affected area qd-tid

Note:

• Affected area may be covered with a bandage after application

[Outline]

• Adult Dosing
• Pediatric Dosing

• First aid to help prevent infections in minor cuts, scrapes, and burns

• Hypersensitivity to any of the ingredients of the product

• N/A

Renal Dose Adjustment

• Renal impairment: No dose adjustments

Hepatic Dose Adjustment

• Hepatic impairment: No dose adjustments

• Indicated for external use only
• Do not apply in the eyes, over large areas of the body, or if the patient is allergic to any of the ingredients
• Do not use therapy for longer than 1 week unless indicated
• Consult a physician before using on deep or puncture wounds, animal bites, or serious burns
• Suspend therapy and consult a physician if the condition persists or gets worse, or if a rash or other allergic reaction develops
• Long-term use of may result in overgrowth of nonsusceptible organisms including fungi
• Cutaneous sensitization may occur, which may present as itching, reddening, edema, or as a failure to heal
• Monitor for signs of a sensitization reaction during prolonged use
• Allergic cross-sensitivity to kanamycin, paromomycin, streptomycin, and gentamycin may occur, which could prevent future use of any or all of the aminoglycoside antibiotics
• Bacterial resistance to these antibiotics may develop

Cautions: Use cautiously in

• Myasthenia gravis

Pregnancy Category:C

Breastfeeding: Safety unknown. Topical bacitracin is poorly excreted in breast milk; hence, considered a low risk to the nursing infant. Water-miscible ointments applied to the breast may expose the infant to high levels of mineral paraffins via licking. Topical neomycin is excreted in very low levels in breastmilk and presents negligible risk to the infant; however, topical application to the nipple may increase the risk of diarrhea in the infant. Polymyxin B is minimally absorbed following topical application; therefore, it poses a low risk to the nursing infant. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 24 June 2011).

• GU: Nephrotoxicity
• EENT: Ototoxicity
• LOCAL: Itching, rash, irritation, allergic contact dermatitis
• HYPERSENSITIVITY: Hypersensitivity reactions, anaphylaxis
• MISC: Superinfection (prolonged use), sensitization

Bacitracin

• Polypeptide antibiotic; inhibits bacterial cell wall synthesis, active against bacterial protoplasts and damages the bacterial plasma membrane
• Minimal systemic absorption
• Not metabolized significantly
• Excretion: Unknown
• Half-life: Unknown

Neomycin

• Aminoglycoside; bactericidal, inhibits protein synthesis in susceptible bacteria by irreversibly binding to 30S ribosomal subunits
• Not absorbed after topical application to intact skin; however, readily absorbed if applied to denuded or abraded skin
• Not metabolized; CYP450: None
• Excreted unchanged in feces (97%)
• Half-life: 2–3 hrs (increased in renal impairment)

Polymyxin B

• Lipopeptide antibiotic; increases bacterial cell permeability by interacting with the lipopolysaccharide component of the cytoplasmic outer membrane of Gram-negative bacteria, causing cell death
• Not absorbed
• Metabolism: Unknown
• Excretion: Unknown
• Half-life: Unknown

US Trade Name(s)

• Neosporin
• Triple Antibiotic

US Availability

Neosporin, Triple Antibiotic (bacitracin/neomycin/polymyxin B)

• OINT: [400 U/3.5 mg/5000 U]/g

Canadian Trade Name(s)

• Neosporin

Canadian Availability

Neosporin (bacitracin/neomycin/polymyxin B)

• OINT: [400 U/3.5 mg/5000 U]/g

UK Trade Name(s)

• N/A

UK Availability

• N/A

Australian Trade Name(s)

• N/A

Australian Availability

• N/A

[Outline]

Antimicrobials

Dermatologic Topical Agents

Antibiotics

Infectious Disease

Dermatologic Topical Agents

Antibiotics

Dermatologic

Dermatologic Topical Agents

Antibiotics