neomycin/polymyxin B/bacitracin/pramoxine

Neomycin/polymyxin B/bacitracin/pramoxine is an antibiotic ointment used topically on minor cuts, scrapes, burns, and wounds to prevent infection and relieve pain. It combines three antibiotics to target a wide range of bacterial strains and includes a local anesthetic. This combination drug is available over the counter (OTC).

The three antibiotics, neomycin, polymyxin B, and bacitracin, are effective against both gram-positive and gram-negative bacteria. Gram-negative bacteria have an additional membrane outside the cell wall that gram-positive bacteria lack. These antibiotics work by inhibiting protein synthesis in bacteria or disrupting the cell membrane. The local anesthetic, pramoxine, provides pain relief.

• Neomycin: Broad-spectrum antibiotic that prevents protein synthesis in bacteria, leading to cell wall damage and death.
• Polymyxin B: Bactericidal drug that disrupts the cell membrane of gram-negative bacteria, causing leakage of cell contents and bacterial death.
• Bacitracin: Polypeptide antibiotic that inhibits cell wall synthesis in gram-positive bacteria, preventing bacterial growth.
• Pramoxine: Local anesthetic that blocks pain signals in the skin by reducing sodium influx into nerve cells.

Warnings

• Do not use if allergic to neomycin, aminoglycosides, or any component of the ointment.
• Prolonged use or application over a large area can be toxic to the ear and kidneys due to systemic absorption.
• Consult a physician before using on serious burns, animal bites, deep or puncture wounds.

Side Effects

Common side effects include itching, rash, allergic contact dermatitis, and hypersensitivity reactions. Seek immediate medical attention for serious symptoms or side effects such as heart symptoms, severe headache or weakness, severe nervous system reaction, or serious eye symptoms.

This is not a complete list of side effects. Consult a doctor for medical advice or report side effects to the FDA.

QUESTION

Dosages

Topical ointment:

• (3.5 mg/10,000 units/500 units/10 mg)/g

Adult and Pediatric:

• Apply a small amount to cleansed wound 1-3 times/day for up to one week.

Overdose:

• Topical application is unlikely to result in overdose. Excessive use may cause bacterial resistance. Oral ingestion can be harmful and should be treated symptomatically.

Drug Interactions

Inform your doctor of all medications you are taking. Neomycin/polymyxin B/bacitracin/pramoxine has no severe, serious, or moderate interactions with other drugs. Mild interaction may occur with certain medications; consult the RxList Drug Interaction Checker for more information.

Pregnancy and breastfeeding

• Use during pregnancy should be cautious and only if clearly needed.
• It is not known if the drug is present in breastmilk; use with caution while nursing.
• Consult a healthcare provider before using any OTC drug if pregnant or breastfeeding.

Additional Information

• Apply the ointment as directed and avoid contact with eyes or large skin areas.
• Discontinue and consult a physician if condition worsens or allergic reactions occur, or if symptoms persist for more than a week or recur frequently.

Summary

Neomycin/polymyxin B/bacitracin/pramoxine is an antibiotic ointment that prevents infection and relieves pain in minor cuts, scrapes, burns, and wounds. Common side effects include itching, rash, allergic contact dermatitis, and hypersensitivity reactions. Consult a doctor if pregnant or breastfeeding.