A fixed-dose topical combination therapy 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 otitis externa. The combination provides broad-spectrum coverage against common skin pathogens while simultaneously reducing inflammation and pruritus.
Adult: Apply a thin layer to the affected area 2-3 times daily, or as directed by the physician. For otitis externa: 2-3 drops instilled into the affected ear 3-4 times daily.
Note: 1. Wash and dry the affected area thoroughly. 2. Take a small amount of cream/ointment on a clean finger. 3. Apply a thin film and rub gently until it disappears. 4. Wash hands before and after application, unless hands are the treatment site. 5. Do not cover with tight bandages or occlusive dressings unless specifically advised by the doctor. For ears: Clean and dry the ear canal before instilling drops.
This combination exerts a triple action: 1) ANTI-INFLAMMATORY: Beclometasone binds to glucocorticoid receptors, inhibiting phospholipase A2, thereby reducing the synthesis of prostaglandins and leukotrienes. It suppresses the release of inflammatory cytokines, inhibits leukocyte migration, and causes vasoconstriction. 2) ANTIFUNGAL: Clotrimazole inhibits the synthesis of ergosterol, a critical component of the fungal cell membrane, by blocking the cytochrome P450-dependent 14α-demethylase enzyme. This leads to increased membrane permeability and cell death. 3) ANTIBACTERIAL: Gentamicin is a bactericidal aminoglycoside that binds to the 30S ribosomal subunit, inhibiting bacterial protein synthesis, leading to misreading of mRNA and cell death.
Pregnancy: Category C (US FDA). Topical corticosteroids, including beclometasone, should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Use should be limited in amount and duration. Avoid large areas or prolonged use. Clotrimazole and gentamicin are generally considered low risk topically.
Driving: No known effects on driving ability.
| Other Topical Corticosteroids | Additive risk of skin atrophy and systemic side effects. | Major |
| Other Aminoglycosides (Systemic e.g., Amikacin, Tobramycin) | Increased risk of ototoxicity and nephrotoxicity if significant topical absorption occurs. | Moderate |
| Loop Diuretics (e.g., Furosemide) | Potentiates the ototoxic risk of gentamicin. | Moderate |
| Neuromuscular Blocking Agents (e.g., Succinylcholine) | Gentamicin may potentiate neuromuscular blockade. | Moderate |
Same composition (Beclometasone (0.5% w/w) + Clotrimazole (1% w/w) + Gentamicin (0.10% w/w)), different brands: