This combination is indicated for the treatment of topical bacterial infections. It is particularly effective in atopic dermatitis, contact dermatitis, stasis dermatitis, infected eczema, eczematoid dermatitis, neurodermatitis, eczema, and anogenital pruritus. It may also be used as an adjunct in certain pyodermas such as impetigo, along with systemic antibiotic therapy when required.

Bacitracin inhibits bacterial cell wall synthesis and is active against many gram-positive organisms such as staphylococci, streptococci, corynebacteria, and clostridia, as well as some gram-negative organisms like Neisseria and Haemophilus influenzae. It is commonly used in topical combinations as a broad-spectrum antibacterial agent.

Neomycin is an aminoglycoside antibiotic with a spectrum similar to gentamicin. It binds to the 30S ribosomal subunit, inhibiting bacterial protein synthesis and thereby interfering with DNA-related processes. It is active against many gram-negative aerobic bacteria and some strains of staphylococci.

Ointment: Before use, the area for application should be cleaned gently. Debris such as pus or crusts should be removed from the affected area. Apply two to three times daily to the affected skin area.

Dusting Powder: Antibiotic powder is a non-sterile dusting powder and used for superficial skin infections. A light dusting of the powder is to be applied to the affected skin area up to 4 times daily.

Bacitracin Zinc: Increased risk of nephrotoxicity when used with other nephrotoxic drugs. It may also enhance the effect of neuromuscular-blocking agents.

Neomycin Sulphate: May cause additive nephrotoxic and neurotoxic effects when used with other aminoglycosides, bacitracin, cisplatin, vancomycin, amphotericin B, polymyxin B, colistin, and viomycin. Toxicity may be increased with potent diuretics. It may reduce absorption of other drugs. It may enhance the effect of acarbose and non-depolarizing muscle relaxants. It may reduce the effect of neostigmine and pyridostigmine. It may increase the risk of hypocalcaemia with bisphosphonates and alter INR when used with anticoagulants. It may also inactivate oral typhoid vaccine.

Hypersensitivity to any of the components of the preparation.

This preparation is generally well tolerated. In rare cases, allergic reactions may occur.

The safety of this preparation during pregnancy and lactation has not been established. It should be used during pregnancy only if the potential benefit outweighs the potential risk to the fetus.

This antibiotic ointment should not be used on large open wounds, severely damaged skin, or heavily exudative areas as hard crust formation may occur. It should not be used in otitis externa with perforated eardrum due to risk of ototoxicity.

Patients using it for deep wounds, animal bites, or serious burns should first consult a physician. If used for minor skin injuries, it should be discontinued and medical advice sought if the condition persists or worsens. It should not be used for more than 1 week unless prescribed.

Children may use the same dose as adults, but reduced dosing is required in infants. Use in neonates is not recommended.

Ophthalmic and topical antibacterial products

Keep out of reach of children. Store in a cool, dry place protected from light.