A potent topical combination therapy consisting of a super-high potency corticosteroid (Clobetasol propionate) and an aminoglycoside antibiotic (Gentamicin sulfate). It is primarily indicated for the treatment of inflammatory dermatoses with secondary or suspected bacterial infections, particularly those caused by susceptible Gram-negative bacteria. The combination provides anti-inflammatory, immunosuppressive, vasoconstrictive, and antibacterial actions.
Adult: Apply a thin film to the affected area once or twice daily. The frequency should be reduced as the condition improves. Maximum duration: 2 weeks. Maximum weekly dose: Do not exceed 50 grams per week.
Note: 1. Wash and dry the affected area gently. 2. Apply a thin layer and rub in lightly until it disappears. 3. Do not bandage, wrap, or cover the area unless specifically directed by the physician (occlusive dressings dramatically increase absorption and risk of side effects). 4. Wash hands after application unless hands are the treated area. 5. Avoid contact with eyes, mouth, nose, and other mucous membranes.
The combination exerts a dual mechanism: 1) Clobetasol propionate binds to intracellular glucocorticoid receptors, modulating gene transcription to inhibit the production of pro-inflammatory mediators (cytokines, chemokines, adhesion molecules) and induce anti-inflammatory proteins (lipocortin). This results in potent anti-inflammatory, immunosuppressive, anti-proliferative, and vasoconstrictive effects. 2) Gentamicin sulfate is a bactericidal antibiotic that binds irreversibly to the 30S ribosomal subunit of susceptible bacteria, inhibiting protein synthesis and causing misreading of mRNA, leading to bacterial cell death.
Pregnancy: 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 the potential benefit justifies the potential risk to the fetus. Avoid large doses, prolonged use, and occlusive dressings.
Driving: No known effects on driving ability.
| Other Topical Corticosteroids | Additive risk of local and systemic side effects, including skin atrophy and HPA suppression. | Major |
| Systemic Corticosteroids (e.g., Prednisolone) | Increased risk of Cushingoid symptoms and HPA axis suppression. | Major |
| Other Aminoglycosides (Systemic e.g., Amikacin) | Increased risk of ototoxicity and nephrotoxicity if systemic absorption of topical gentamicin occurs. | Major |
| Loop Diuretics (e.g., Furosemide) | Increased risk of ototoxicity when combined with systemically absorbed gentamicin. | Moderate |
| Neuromuscular Blocking Agents (e.g., Succinylcholine) | Gentamicin may potentiate neuromuscular blockade, leading to respiratory depression. | Moderate |
| Live Vaccines | Clobetasol may diminish the immunological response to live vaccines, increasing the risk of infection. | Moderate |
Same composition (Clobetasol (0.05% w/w) + Gentamicin (0.1% w/w)), different brands: