A fixed-dose combination topical preparation containing a potent corticosteroid (Betamethasone) and an aminoglycoside antibiotic (Gentamicin). It is primarily used for the treatment of inflammatory dermatoses complicated by secondary bacterial infections, particularly those caused by susceptible Gram-negative bacteria. The combination provides anti-inflammatory, immunosuppressive, antipruritic, and antibacterial actions.
Adult: Apply a thin film to the affected area 1 to 2 times daily. Duration should be limited, typically 1-2 weeks. Use the minimal amount necessary.
Note: Wash and dry the affected area gently. Apply a thin layer and rub in lightly. Do not bandage or cover with occlusive dressings unless specifically directed by a physician. Wash hands before and after application, unless hands are the treatment area. Do not use in or near the eyes.
Betamethasone exerts potent anti-inflammatory, immunosuppressive, and antipruritic effects by inducing phospholipase A2 inhibitory proteins (lipocortins), which inhibit the release of arachidonic acid from membrane phospholipids, thereby reducing the synthesis of prostaglandins and leukotrienes. It also inhibits the expression of cytokines (IL-1, IL-2, IL-6, TNF-α), reduces capillary permeability, and suppresses migration of polymorphonuclear leukocytes and fibroblasts. Gentamicin is a bactericidal aminoglycoside that binds irreversibly to the 30S ribosomal subunit of susceptible bacteria, inhibiting protein synthesis and causing misreading of the genetic code.
Pregnancy: Category C (US FDA). Topical corticosteroids, especially potent ones, can be absorbed in amounts sufficient to cause systemic effects. Animal studies show teratogenicity. Use only if potential benefit justifies potential risk to the fetus. Avoid large amounts, prolonged use, or occlusive dressings.
Driving: No known effects on driving ability from topical use.
| Other Topical Corticosteroids | Increased risk of local and systemic side effects (additive effect). | Major |
| Systemic Corticosteroids (e.g., Prednisolone) | Increased risk of systemic corticosteroid side effects and HPA axis suppression. | Major |
| Other Nephrotoxic drugs (e.g., NSAIDs, Vancomycin, Cyclosporine) | Increased risk of gentamicin-induced nephrotoxicity if systemically absorbed. | Moderate |
| Other Ototoxic drugs (e.g., Loop Diuretics - Furosemide) | Increased risk of gentamicin-induced ototoxicity if systemically absorbed. | Moderate |
| Neuromuscular Blocking Agents (e.g., Succinylcholine) | Gentamicin may potentiate neuromuscular blockade. | Moderate |
Same composition (Betamethasone (0.05% w/w) + Gentamicin (0.1% w/w)), different brands: