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Bacitracin Zinc / Neomycin Sulfate / Polymyxin B Sulfate / Hydrocortisone

Trade Names:
Cortisporin
- Ointment 400 units/g bacitracin zinc, 3.5 mg/g neomycin, 5,000 units/g polymyxin B, 1% hydrocortisone

Mechanism of Action

Pharmacology

Inhibits protein synthesis by binding to ribosomal RNA, causing bacterial genetic code misreading.

Interacts with phospholipid components of bacterial cell membrane, increasing cell wall permeability.

Interferes with bacterial cell wall synthesis by inhibiting regeneration of phospholipid receptors involved with paptidoglycan synthesis.

Suppresses inflammatory response.

Indications and Usage

Treatment of corticosteroid-responsive dermatoses with secondary infection.

Contraindications

Use in the eyes or external ear canal (if the eardrum is perforated); tuberculosis; fungal or viral (eg, varicella zoster) lesions of the skin; hypersensitivity to any of components of product.

Dosage and Administration

Topical Apply thin film to affected area 2 to 4 times daily, not to exceed 7 days.

Storage/Stability

Store at controlled room temperature (59° to 86°F). Keep tube tightly closed.

Drug Interactions

None well documented.

Laboratory Test Interactions

None well documented.

Adverse Reactions

Dermatologic

Acneiform eruption, allergic contact dermatitis, burning, dryness, folliculitis, hypertrichosis, hypopigmentation, itching, maceration of the skin, miliaria, perioral dermatitis, secondary infection, skin atrophy, skin sensitization, striae.

EENT

Ototoxicity.

Genitourinary

Nephrotoxicity.

Miscellaneous

Allergic sensitivity.

Precautions

Pregnancy

Category C .

Lactation

Hydrocortisone is excreted in breast milk following oral administration.

Children

Safety and efficacy in children not established.

Superinfection

Prolonged use may result in bacterial or fungal overgrowth of nonsusceptible microorganisms.

Adrenal suppression

Signs and symptoms of exogenous hyperadrenocorticism can occur with use of topical corticosteroids, especially if occlusive dressings are used.

Bacterial resistance

Bacterial resistance to components of the product may develop.

Patient Information

• Review prescribed dosing schedule with patient or caregiver.
• Remind patient or caregiver that ointment is not to be used in the eye or ear (if the eardrum is perforated).
• Teach patient or caregiver proper technique for applying ointment: Wash hands; apply thin film to affected area(s) using fingers or applicator. Wash hands after applying ointment.
• Advise patient or caregiver to contact health care provider if local redness or swelling develops or if skin lesions do not improve or worsen.