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Action/Kinetics:
Peak plasma levels: PO, 1-4 hr;
Therapeutic serum level: 5-10 mcg/mL.
t
1/2: 2-3 hr.
Uses:
PO: Hepatic coma, sterilization of gut prior to surgery, inhibition of ammonia-forming bacteria in GI tract in hepatic encephalopathy. Therapy of intestinal infections due to pathogenic strains of
Escherichia coli primarily in children.
Investigational: Hypercholesterolemia.
Topical: Prophylaxis or treatment of infection in burns, minor cuts, wounds, and skin abrasions. As an aid to healing and for treating superficial skin infections.
Additional Contraindications:
Intestinal obstruction (PO). Use of topical products in or around the eyes.
Special Concerns:
Safe use during pregnancy has not been determined. Due to the possibility of toxicity, some recommend not to use parenteral neomycin for any purpose. Use with caution in clients with extensive burns, trophic ulceration, or other conditions where significant systemic absorption is possible.
Side Effects:
Chronic use of topical neomycin to inflamed skin of those with contact dermatitis and chronic dermatosis increases the chance of hypersensitivity. Ototoxicity, nephrotoxicity. Sprue-like syndrome with steatorrhea, malabsorption, and electrolyte imbalance. Skin rashes after topical or parenteral administration. Chronic use in allergic contact dermatitis and chronic dermatoses increases the risk of sensitization.
Additional Drug Interactions:
-
Digoxin /
Digoxin effect R/T
GI tract absorption
-
Penicillin V /
PCN effect R/T
GI tract absorption
-
Procainamide /
Muscle relaxation produced by neomycin
How Supplied:
Cream: 5 mg/g;
Ointment: 5 mg/g;
Solution: 125 mg/5 mL;
Tablet: 500 mg
Dosage
?Oral Solution
Preoperatively in colorectal surgery.
1 g each of neomycin and erythromycin base for a total of three doses: the first two doses 1 hr apart the afternoon before surgery and the third dose at bedtime the night before surgery.
Hepatic coma, adjunct.
Adults, 4-12 g/day in divided doses for 5-6 days;
children: 50-100 mg/kg/day in divided doses for 5-6 days.
?Topical Cream, Ointment
Neomycin alone or in combination with other antibiotics (bacitracin or gramicidin) and/or an anti-inflammatory agent (corticosteroid). Apply ointment (0.5%) or cream (0.5%) 1-3 times/day to affected area. If necessary, a bandage may be used to cover the area.
