Neomycin Sulphate 0.5% + Prednisolone 0.5% E/E prep
Indications
Neomycin Sulphate 0.5% + Prednisolone 0.5% E/E prep is used for:
Bacterial ocular infection, otitis externa
Adult Dose
Conjunctivitis
Adult: Instill 1-2 drops into the affected eye(s) 2-4 times daily.
Otic/Aural
Allergic and inflammatory conditions of the ear
Adult:1-2 drops into the affected ear 3-4 times daily.
Child Dose
Conjunctivitis
Child: Instill 1-2 drops into the affected eye(s) 2-4 times daily.
Otic/Aural
Allergic and inflammatory conditions of the ear
Child:1-2 drops into the affected ear 3-4 times daily.
Renal Dose
Administration
Contra Indications
Epithelial herpes simplex keratitis (dendritic keratitis), vaccinia, varicella, and many other viral diseases of the cornea and conjunctiva. Mycobacterial infection of the eye. Fungal diseases of the ocular structures. Hypersensitivity to a component of the medication. (Hypersensitivity to the antibiotic component occurs at a higher rate than for other components.)
The use of these combinations is always contraindicated after uncomplicated removal of a corneal foreign body.
Precautions
The possibility of persistent fungal infections of the cornea should be considered after prolonged steroid dosing.
Prolonged use may result in overgrowth of nonsusceptible organisms, including fungi. If superinfection occurs, appropriate therapy should be initiated.
If purulent discharge, inflammation, or pain becomes aggravated, the patient should discontinue use of the medicatioin and consult a physician.
Allergic cross-reactions may occur which could prevent the use of any or all of the following antibiotics for the treatment of future infections: kanamycin, paromomycin, streptomycin, and possibly gentamicin.
Pregnancy-Lactation
Interactions
Synergistic effects with penicillins. Additive toxicity with neurotoxic, ototoxic or nephrotoxic drugs. May decrease absorption of digoxin and methotrexate. May increase effects of oral anticoagulants.
Adverse Effects
Side effects of Neomycin Sulphate 0.5% + Prednisolone 0.5% E/E prep :
Ophthalmic: Raised IOP and reduced visual function.
Ear: Discomfort & pain in ear.
Fungal and viral infections of the cornea are particularly may develop coincidentally with long-term applications of steroid.
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.
Prednisolone decreases inflammation by inhibition of migration of polymorphonuclear leukocytes and reversal of increased capillary permeability. It suppresses the immune system by reducing the activity and production of the lymphocytes and eosinophils.