Hydrocortisone/neomycin/polymyxin: Difference between revisions
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*Type: topical [[antibiotic]]/[[steroid]] | *Type: topical [[antibiotic]]/[[steroid]] | ||
*Dosage Forms: 3.5 mg/10,000 units/10 mg per mL | *Dosage Forms: 3.5 mg/10,000 units/10 mg per mL | ||
*Routes of Administration: topical | *Routes of Administration: topical, otic | ||
*Common Trade Names: Cortisporin otic | *Common Trade Names: Cortisporin otic | ||
==Adult Dosing== | ==Adult Dosing== | ||
*4 drops in ear q6-8hr | *4 drops in ear q6-8hr | ||
*Max: 10 days | |||
==Pediatric Dosing== | ==Pediatric Dosing== | ||
*3 drops in ear q6-8hr | *3 drops in ear q6-8hr | ||
*Max: 10 days | |||
==Special Populations== | ==Special Populations== | ||
*[[Pregnancy Rating]]: Category C | |||
*[[Lactation risk]]: Unknown whether drug is excreted in milk; use with caution | |||
===Renal Dosing=== | ===Renal Dosing=== | ||
*Adult: | *Adult: n/a | ||
*Pediatric: | *Pediatric: n/a | ||
===Hepatic Dosing=== | ===Hepatic Dosing=== | ||
*Adult: | *Adult: n/a | ||
*Pediatric: | *Pediatric: n/a | ||
==Contraindications== | ==Contraindications== | ||
| Line 32: | Line 31: | ||
==Adverse Reactions== | ==Adverse Reactions== | ||
===Serious=== | ===Serious=== | ||
*Ototoxicity | |||
*Neomycin sensitization with itching, reddening, edema, and failure to heal | *Neomycin sensitization with itching, reddening, edema, and failure to heal | ||
*Systemic absorption of topical corticosteroids--> HPA axis suppression --> adrenal crisis | *Systemic absorption of topical corticosteroids--> HPA axis suppression --> adrenal crisis | ||
| Line 43: | Line 43: | ||
*Swelling | *Swelling | ||
==Mechanism of Action== | ==Mechanism of Action== | ||
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==See Also== | ==See Also== | ||
*[[Otitis externa]] | *[[Otitis externa]] | ||
*[[Tympanic membrane perforation]] | |||
==References== | ==References== | ||
Latest revision as of 02:53, 4 March 2020
Administration
- Type: topical antibiotic/steroid
- Dosage Forms: 3.5 mg/10,000 units/10 mg per mL
- Routes of Administration: topical, otic
- Common Trade Names: Cortisporin otic
Adult Dosing
- 4 drops in ear q6-8hr
- Max: 10 days
Pediatric Dosing
- 3 drops in ear q6-8hr
- Max: 10 days
Special Populations
- Pregnancy Rating: Category C
- Lactation risk: Unknown whether drug is excreted in milk; use with caution
Renal Dosing
- Adult: n/a
- Pediatric: n/a
Hepatic Dosing
- Adult: n/a
- Pediatric: n/a
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
- Ototoxicity
- 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
Mechanism of Action
- Hydrocortisone: Suppresses inflammatory response
- Polymyxin: disrupts bacterial cytoplasmic membrane permeability allowing leakage of intracellular contents--> bactericidal
- Neomycin: Inhibits protein synthesis