| NEOMYCIN SULFATE
Mycifradin, Myciguent, Neo-Tabs, Neo-fradin
Classifications: aminoglycoside antibiotic; Therapeutic: antibiotic; aminoglycoside
Pregnancy Category: C
500 mg tablet; 125 mg/5 mL oral solution; 3.5 mg/g ointment, cream
Aminoglycoside antibiotic obtained from Streptomyces fradiae. It inhibits bacterial protein synthesis through irreversible binding to the 30S ribosomal subunit within susceptible bacteria.
Causes bacteria not to replicate.
Active against a wide variety of gram-negative bacteria. Effective against certain gram-positive organisms, particularly
penicillin-sensitive and some methicillin-resistant strains of Staphylococcus aureus (MRSA).
Severe diarrhea caused by enteropathogenic Escherichia coli; preoperative intestinal antisepsis; to inhibit nitrogen-forming bacteria of GI tract in patients with cirrhosis or hepatic
coma and for urinary tract infections caused by susceptible organisms. Also topically for short-term treatment of eye, ear,
and skin infections.
Use of oral drug in patients with intestinal obstruction; ulcerative bowel lesions; topical applications over large skin
areas; hypersensitivity to aminoglycosides; parkinsonism; myasthenia gravis; pregnancy (category C), lactation.
Topical otic applications in patients with perforated eardrum, children; dehydration; renal disease, renal impairment.
Route & Dosage
Adult: PO 1 g q1h x 4 doses, then 1 g q4h x 5 doses
Child: PO 10.3 mg/kg q46h for 3 d
Adult: PO 412 g/d in 4 divided doses for 56 d
Child: PO 437.51225 mg/m2 q6h for 56 d
Adult: PO 50 mg/kg in 4 divided doses for 23 d IM 1.32.6 mg/kg q6h
Child: PO 8.75 mg/kg q6h for 23 d
Adult: Topical Apply 13 times/d
- Preoperative bowel preparation: Saline laxative is generally given immediately before neomycin therapy is initiated.
- Consult physician about what to use for cleansing skin before each application.
- Make sure ear canal is clean and dry prior to instillation for topical therapy of external ear.
Adverse Effects (≥1%)Body as a Whole: Neuromuscular blockade
with muscular and respiratory paralysis
; hypersensitivity reactions. GI:
Mild laxative effect, diarrhea
, nausea, vomiting; prolonged therapy: malabsorption-like syndrome
) deficiency, low serum
cholesterol. Urogenital: Nephrotoxicity. Special Senses: Ototoxicity. Skin: Redness,
scaling, pruritus, dermatitis.
May decrease absorption of cyanocobalamin.
3% absorbed from GI tract in adults; up to 10% absorbed in neonates. Peak:
14 h. Elimination:
97% excreted unchanged in feces. Half-Life:
Assessment & Drug Effects
- Perform audiometric studies twice weekly in patients with kidney or liver dysfunction receiving extended oral therapy.
- Lab tests: Obtain baseline and daily urinalysis for albumin, casts, and cells; and BUN every other day. Also, serum drug
levels (toxic levels reportedly range from 8 to 30 mcg/mL, although individual variations exist).
- Monitor I&O in patients receiving oral or parenteral therapy. Report oliguria or changes in I&O ratio. Inadequate neomycin
excretion results in high serum drug levels and risk of nephrotoxicity and ototoxicity.
Patient & Family Education
- Stop treatment and consult your physician if irritation occurs when you are using topical neomycin. Allergic dermatitis
- Report any unusual symptom related to ears or hearing (e.g., tinnitus, roaring sounds, loss of hearing acuity, dizziness).
- Do not exceed prescribed dosage or duration of therapy.