Indications
Gramicidin is an antibiotic used only on the skin, eyes or ears. It is almost always combined with other medicines, for example with Neomycin and Nystatin and a corticosteroid such as Triamcinolone in creams and ointments for skin conditions that are inflamed and infected with bacteria or yeast (such as infected eczema, nappy rash or intertrigo), or with Neomycin and Polymyxin B in eye and ear drops for bacterial infections.
How It Works
Gramicidin forms tiny channels in the outer membrane of bacteria. Salts leak through these channels, so the bacteria lose their balance and die. It mainly works against Gram-positive bacteria such as Staphylococcus and Streptococcus, and adds to the range of the other antibiotics in the combination.
Dosage and Administration
Creams and ointments: apply a thin layer to the affected area 2 to 3 times a day, or as prescribed, usually for no longer than 1 to 2 weeks. Eye or ear drops: use the number of drops and times a day stated by your doctor or on the label. Wash your hands before and after use. Complete the course your doctor recommends.
Interactions
Gramicidin is not absorbed into the body when used correctly, so it has no known interactions with medicines taken by mouth. Do not use other skin, eye or ear products on the same area at the same time unless your doctor advises it.
Contraindications
- Allergy to Gramicidin or any other ingredient of the combination (for example Neomycin).
- Ear drops: a perforated (burst) eardrum, unless a doctor has approved them.
- Combinations with a steroid: viral skin infections (such as chickenpox, cold sores), tuberculosis of the skin, rosacea and acne.
- It must never be injected or taken by mouth.
Side Effects
Possible effects include burning, stinging, itching, redness or a rash where it is applied. Eye drops may cause brief blurring or irritation. An allergic skin reaction (often to Neomycin in the combination) can make the rash worse. Long use can allow resistant germs or fungi to grow.
Get urgent medical help if you develop swelling of the face, lips or throat, difficulty breathing, a widespread rash, eye pain or a sudden change in vision, or hearing loss or ringing in the ears after using ear drops.
Pregnancy and Lactation
Little is absorbed, but use in pregnancy and breastfeeding only if your doctor advises it, especially for combinations containing a steroid or Neomycin. Do not apply to the breast area when breastfeeding.
Precautions and Warnings
Gramicidin is too toxic to be used inside the body because it damages red blood cells. Use topical products only on the area intended, avoid large areas of broken skin, and do not use for longer than advised. See a doctor if the condition does not improve within a week or becomes worse. Do not touch the dropper tip to the eye or ear.
Overdose
Overuse on the skin is unlikely to cause serious harm, but long use of steroid-containing combinations can thin the skin. If a product is swallowed, contact a doctor or poison centre.
Therapeutic Class
Topical antibacterial (polypeptide antibiotic), used in combination products.
Storage
Store below 30°C in a dry place, away from light and out of the reach of children. Do not freeze. Discard eye drops 4 weeks after opening unless the label says otherwise.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.