G Neomycin

Indications

Neomycin is an antibiotic. It is mostly used on the skin, eyes and ears, often combined with other medicines, to treat or prevent bacterial infection in minor cuts, grazes, burns and wounds. Doctors also use neomycin tablets for a short time to reduce gut bacteria before bowel surgery, and to help manage hepatic encephalopathy (confusion caused by severe liver disease).

How It Works

Neomycin belongs to the aminoglycoside group of antibiotics. It stops bacteria from making the proteins they need, which kills them. Very little is absorbed from the gut or from unbroken skin, so it works mainly where it is applied or inside the bowel.

Dosage and Administration

• Cream, ointment or powder: apply a thin layer to the affected area 1 to 3 times a day, usually for no more than 7 days unless the doctor advises longer.
• Eye or ear drops: as directed on the pack or by the doctor.
• Tablets: only as prescribed by a doctor, for a short course.

Wash your hands before and after use. Do not use on large areas of broken skin.

Interactions

When neomycin is absorbed (tablets, or use on large wounds), it can add to the kidney and hearing damage caused by other aminoglycosides such as Gentamicin and Amikacin, strong water tablets such as Furosemide, Vancomycin and Ciclosporin. Tablets may lower the absorption of Digoxin and Phenoxymethylpenicillin, may increase the effect of Warfarin, and can strengthen muscle relaxants used during anaesthesia.

Contraindications

• Allergy to neomycin or to other aminoglycoside antibiotics.
• Tablets: blockage of the bowel or myasthenia gravis (a muscle weakness disease).
• Ear drops: a hole in the eardrum.

Side Effects

On the skin: itching, redness or rash, which can mean an allergy, especially after long use. Tablets: nausea, vomiting and diarrhoea.

Get urgent medical help if you notice hearing loss, ringing in the ears or dizziness, passing much less urine than usual, swelling of the face, lips or throat or difficulty breathing, or severe or bloody diarrhoea.

Pregnancy and Lactation

Neomycin tablets should be avoided in pregnancy, because absorbed aminoglycosides can harm the hearing of the unborn baby. Short use on a small area of skin is generally considered low risk, but ask a doctor first. Very little reaches breast milk from skin use; ask a doctor before using tablets while breastfeeding.

Precautions and Warnings

Do not use on large or deep wounds, large burns or for long periods, because more medicine is absorbed and can damage hearing and kidneys. Take extra care in older people and in kidney disease. Stop and see a doctor if the skin becomes more red, itchy or swollen. Long use can allow fungi or resistant bacteria to grow.

Overdose

Applying too much to the skin rarely causes harm. If too many tablets are taken, kidney and hearing damage are possible; get medical help promptly.

Therapeutic Class

Aminoglycoside antibiotic.

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.