Hydrocortisone/neomycin/polymyxin

Administration

• Type: topical antibiotic/steroid
• Dosage Forms:
• Routes of Administration: topical
• Common Trade Names: Cortisporin otic

Adult Dosing

• 4 drops in ear q6-8hr

Pediatric Dosing

• 3 drops in ear q6-8hr

Special Populations

Pregnancy Rating

• Category C

Lactation risk

• Unknown whether drug is excreted in milk; use with caution

Renal Dosing

• Adult:
• Pediatric:

Hepatic Dosing

• Adult:
• Pediatric:

Contraindications

• Allergy to class/drug
• Cutaneous viral infection of the external auditory canal (e.g. patients with herpes simplex, vaccinia, and varicella infections)

Adverse Reactions

Serious

• Neomycin sensitization with itching, reddening, edema, and failure to heal
• Systemic absorption of topical corticosteroids--> HPA axis suppression --> adrenal crisis
• Prolonged use of corticosteroids may lead to increase incidence of infection, masking of infection, limited response to vaccines
• Prolonged use of corticosteroids associated with development of Kaposi sarcoma

Common

• Itching
• Redness
• Rash
• Swelling

Pharmacology

• Half-life:
• Metabolism:
• Excretion:

Mechanism of Action

• Hydrocortisone: Suppresses inflammatory response
• Polymyxin: disrupts bacterial cytoplasmic membrane permeability allowing leakage of intracellular contents--> bactericidal
• Neomycin: Inhibits protein synthesis

See Also

• Otitis externa