A fixed-dose combination topical preparation containing three antibiotics (Polymyxin B, Neomycin, Bacitracin) and a corticosteroid (Hydrocortisone). It is primarily used for the treatment and prevention of bacterial infections in superficial skin conditions where inflammation is present. The combination provides broad-spectrum antibacterial coverage against Gram-positive and Gram-negative organisms, while Hydrocortisone reduces inflammation, itching, and edema.
Adult: Apply a thin layer to the affected area 2 to 4 times daily, depending on severity. Duration should be limited, typically 5-7 days, or as directed by the physician.
Note: Wash and dry the affected area gently. Apply a thin film and rub in gently. Wash hands before and after application unless hands are the treated area. Do not cover with tight bandages or occlusive dressings unless advised by a doctor. Do not use in the eyes.
The combination exerts a synergistic antibacterial and anti-inflammatory action. Polymyxin B disrupts the outer membrane of Gram-negative bacteria. Neomycin inhibits bacterial protein synthesis by binding to the 30S ribosomal subunit. Bacitracin inhibits cell wall synthesis in Gram-positive bacteria. Hydrocortisone binds to glucocorticoid receptors, inducing anti-inflammatory proteins and inhibiting pro-inflammatory mediators.
Pregnancy: Category C (US FDA). Topical use may be considered if potential benefit justifies potential risk. Use the minimum effective amount for the shortest duration. Avoid large areas or long-term use.
Driving: No effect.
| Other Topical Corticosteroids | Increased risk of local and systemic steroid adverse effects. | Major |
| Other Aminoglycosides (e.g., Gentamicin, systemic) | Increased risk of ototoxicity and nephrotoxicity if neomycin is systemically absorbed. | Moderate |
| Neuromuscular Blocking Agents | Neomycin may potentiate neuromuscular blockade if significantly absorbed. | Moderate |
| Loop Diuretics (e.g., Furosemide) | May enhance the ototoxic potential of neomycin. | Moderate |
Same composition (Polymyxin B (5000units) + Neomycin (3400units) + Bacitracin (400units) + Hydrocortisone (10mg)), different brands: