Dosage Forms
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Ointment, Ophthalmic:
Neo-Polycin: Bacitracin 400 units, neomycin 3.5 mg, and polymyxin B 10,000 units per g (3.5 g)
Generic: Bacitracin 400 units, neomycin 3.5 mg, and polymyxin B 10,000 units per g (3.5 g)
Pharmacology
Mechanism of Action
Bacitracin: Inhibits bacterial cell wall synthesis by preventing transfer of mucopeptides into the growing cell wall.
Neomycin: Interferes with bacterial protein synthesis by binding to 30S ribosomal subunits.
Polymyxin B: Binds to phospholipids, alters permeability, and damages the bacterial cytoplasmic membrane permitting leakage of intracellular constituents.
Use: Labeled Indications
Ocular infections: Treatment of superficial external ocular infections (eg, conjunctivitis, keratitis, keratoconjunctivitis, blepharitis, blepharoconjunctivitis) caused by susceptible organisms.
Contraindications
Hypersensitivity to neomycin, polymyxin B, bacitracin, or any component of the formulation
Dosage and Administration
Dosing: Adult
Ocular infections: Ophthalmic: Apply every 3 to 4 hours for 7 to 10 days.
Dosing: Geriatric
Refer to adult dosing.
Dosing: Pediatric
Conjunctivitis: Limited data available: Children and Adolescents: Ophthalmic: Apply 0.5 inch ribbon every 3 to 4 hours for acute infections, or 2 to 3 times per day for mild to moderate infections, for 7 to 10 days (Pichichero 2011)
Administration
For ophthalmic use only; not for injection into the eye. Avoid contamination of the tip of the ointment tube.
Storage
Store at room temperature.
Drug Interactions
There are no known significant interactions.
Adverse Reactions
Frequency not defined.
Dermatologic: Reddening, allergic contact dermatitis
Local: Itching, failure to heal, swelling, irritation
Ophthalmic: Conjunctival edema
Miscellaneous: Anaphylaxis
Warnings/Precautions
Concerns related to adverse effects:
- Neomycin sensitization: Neomycin may cause cutaneous sensitization. Symptoms of neomycin sensitization include itching, reddening, edema, and failure to heal. Discontinuation of product and avoidance of similar products should be considered.
- Ocular effects: May retard corneal wound healing.
- Superinfection: Prolonged use may lead to overgrowth of nonsusceptible organisms, including fungi. If superinfection is suspected, institute appropriate alternative therapy.
Other warnings/precautions:
- Appropriate use: For topical ophthalmic use only. Do not introduce directly into anterior chamber of the eye. Inadvertent contamination of multiple-dose ophthalmic tube tip has caused bacterial keratitis.
Pregnancy
Pregnancy Risk Factor
C
Pregnancy Considerations
Animal reproduction studies have not been conducted with this combination.
Patient Education
- Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)
- Have patient report immediately to prescriber vision changes, eye pain, severe eye irritation, or eye discharge (HCAHPS).
- Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.
Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for health care professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience, and judgment in diagnosing, treating, and advising patients.
