Bacitracin Zinc + Neomycin Sulphate Eye prep
Indications
Bacitracin Zinc + Neomycin Sulphate Eye prep is used for:
Bacterial ocular infections
Adult Dose
A thin film to be applied 2 to 4 times daily
Child Dose
A thin film to be applied 2 to 4 times daily
Renal Dose
Administration
Before use, the area for application should be cleaned gently. Debris such as pus or crusts should be removed from the affected area.
Contra Indications
This product is contraindicated in those individuals who have shown hypersensitivity to any of its components.
Glaucoma. Viral diseases of cornea and conjunctiva (epithelial herpes simplex keratitis, vaccinia, varicella)
Mycobacterial infection of eye & fungal diseases of ocular structures
Precautions
Excessive use of the topical preparation may lead to substantial systemic absorption which may lead to neurotoxicity (bacitracin). Prolonged use of the antibacterial preparation may cause overgrowth of non-susceptible organisms, including fungi. Pregnancy and lactation.
Lacation: Excretion in breast milk unknown; caution
Pregnancy-Lactation
Interactions
Bacitracin Zinc: Increased risk of nephrotoxicity when used with other nephrotoxic drugs. May enhance the action of neuromuscular-blocking agents.
Neomycin Sulphate: Additive nephrotoxic and neurotoxic effect w/ other aminoglycosides (e.g. paromomycin), bacitracin, cisplatin, vancomycin, amphotericin B, polymyxin B, colistin and viomycin. Enhanced toxicity w/ potent diuretics (e.g. ethacrynic acid, furosemide). May impair the absorption of other drugs (e.g. phenoxymethylpenicillin, digoxin, methotrexate and some vit). May reduce the efficacy of OCs. May enhance the effect of acarbose. May enhance the effect of non-depolarising muscle relaxants. May antagonise the parasympathomimetic effect of neostigmine and pyridostigmine. May increase the risk of hypocalcaemia in patients receiving bisphosphonates. May alter INR when given w/ anticoagulants. May inactivate oral typhoid vaccine.
Adverse Effects
Side effects of Bacitracin Zinc + Neomycin Sulphate Eye prep :
Excessive use of the topical preparation may lead to substantial systemic absorption which may lead to nephrotoxicity (polymyxin B sulfate) and neurotoxicity (bacitracin). Prolonged use of the antibacterial preparation may cause overgrowth of non-susceptible organisms, including fungi. Pregnancy and lactation.
Lacation: Excretion in breast milk unknown; caution
Mechanism of Action
Neomycin, an aminoglyoside with antimicrobial spectrum similar to gentamicin, binds to the 30S subunits of the bacterial ribosome, inhibiting protein synthesis and thereby disrupting DNA synthesis. It is active against many gram-negative aerobes and against some strains of staphylococci.
Bacitracin, on the other hand, inhibits bacterial cell wall synthesis and is active against many gram-positive bacteria (e.g. staphylococci, streptococci, corynebacteria and clostridia) and some gram-negative species (e.g. Neisseria and Haemophilus influenzae). They are often found in combinations in topical preparations as broad spectrum antibacterial agents.