A fixed-dose combination topical preparation containing a corticosteroid (Beclometasone dipropionate), an antifungal (Clotrimazole), and an aminoglycoside antibiotic (Gentamicin sulfate). It is primarily indicated for the treatment of mixed dermatological infections where inflammation, fungal overgrowth, and bacterial infection coexist, commonly seen in conditions like infected eczema, intertrigo, and infected dermatophytosis. The combination provides broad-spectrum coverage against common skin pathogens while reducing inflammation and pruritus.
Adult: Apply a thin layer to the affected area 2 to 3 times daily. Duration should be limited, typically 1-2 weeks, or as directed by the physician.
Note: 1. Wash and dry the affected area thoroughly. 2. Take a small amount of cream on clean fingertips. 3. Apply a thin film and rub gently until absorbed. 4. Wash hands after application unless hands are the treatment site. 5. Do not cover with occlusive dressings unless specifically advised. 6. Avoid contact with eyes, nose, mouth, and mucous membranes.
The combination exerts a triple action: 1) Beclometasone suppresses inflammation, itching, and cellular immune responses by inducing phospholipase A2 inhibitory proteins (lipocortins). 2) Clotrimazole inhibits the synthesis of ergosterol, a critical component of fungal cell membranes, leading to increased membrane permeability and cell death. 3) Gentamicin binds to the 30S ribosomal subunit of susceptible bacteria, inhibiting protein synthesis and causing bactericidal effects.
Pregnancy: Category C (US FDA). Topical corticosteroids, clotrimazole, and gentamicin can be absorbed systemically. Use only if clearly needed and potential benefit justifies potential risk to the fetus. Avoid large amounts, prolonged use, or application under occlusion. Consult physician.
Driving: No effect on driving ability.
| Other Topical Corticosteroids (e.g., Betamethasone, Mometasone) | Additive risk of skin atrophy and systemic side effects. | Major |
| Other Aminoglycosides (e.g., Neomycin, Tobramycin) - systemic or topical | Increased risk of ototoxicity and nephrotoxicity. | Major |
| Loop Diuretics (e.g., Furosemide) | Potentiates gentamicin ototoxicity. | Moderate |
| Neuromuscular Blocking Agents (e.g., Succinylcholine) | Gentamicin may potentiate neuromuscular blockade. | Moderate |
| CYP3A4 Inhibitors (e.g., Ketoconazole, Itraconazole, Clarithromycin) | May increase systemic levels of beclometasone, increasing steroid side effects. | Moderate |
Same composition (Beclometasone (0.025%) + Clotrimazole (1%) + Gentamicin (0.1%)), different brands: