This ointment is used in the treatment of infected wounds, burns, and skin grafts. It is also valuable in preparing donor sites for skin grafting and in preventing infection in extensive burns and contaminated wounds. It is effective in the local treatment of chronic varicose ulcers and other indolent ulcers. The preparation is also used in conditions such as furuncles, carbuncles, pyoderma, sycosis barbae, impetigo, and acne. It may also be used for secondary infected skin lesions in scabies, pediculosis, tinea pedis, and contact or allergic dermatitis.

Each gram of ointment contains:

• Neomycin Sulphate BP 3.5 mg
• Bacitracin Zinc BP 400 IU
• Polymyxin B Sulphate BP 5000 IU

This combination of Polymyxin B sulphate, Neomycin, and Bacitracin zinc is considered a broad-spectrum topical antibacterial preparation. All three components are bactericidal and together cover a wide range of pathogenic organisms commonly found in skin infections. Topical application results in minimal systemic absorption and low irritation. Polymyxin B sulphate is active mainly against gram-negative bacteria, including Pseudomonas aeruginosa, which is often resistant to many antibiotics, making it useful in Pseudomonas infections. Neomycin acts against both gram-positive and gram-negative bacteria, including many strains of Proteus, and is particularly effective against Staphylococcus aureus, a common skin pathogen. Bacitracin zinc is effective against gram-positive organisms, including streptococci, and broadens the antibacterial coverage of the formulation. The combined overlapping activity enhances overall antimicrobial effectiveness.

Adult: This Ointment should be applied thinly over the affected area after cleaning it.1-3 daily applications should be continued until the infection is controlled and healing completely.

Children and Infants: This Ointment is suitable for use in children at the same dose as adults, but the dose should be reduced in infants. This ointment is not recommended for use in neonates.

This ointment should not be used in individuals with known hypersensitivity to any of its components. Increased systemic absorption may occur in very young children; therefore, it is not recommended for use in neonates.

Common side effects include nausea, vomiting, pain, burning or swelling, skin rash, possible kidney problems, hearing loss, dizziness, unusual skin numbness, muscle twitching, seizures, redness and swelling at the application site.

There is limited information regarding the effects of topical neomycin during pregnancy and lactation. However, neomycin can be absorbed into maternal blood, cross the placenta, and may theoretically pose a risk of fetal toxicity. Therefore, this ointment is not recommended during pregnancy and breastfeeding.

This ointment is not intended for sterile surgical use, such as in abdominal or thoracic cavities. Evidence shows that neomycin, when in contact with peritoneal or pleural tissues, may potentiate neuromuscular blockade in patients receiving muscle relaxants, potentially causing respiratory paralysis. As with other antibiotics, prolonged use may lead to overgrowth of non-susceptible organisms. Neomycin-related ototoxicity has been reported. In neonates and infants, increased absorption through immature skin and immature renal function may increase risk of toxicity.

Topical Antibiotic preparations

Store below 30°C. Keep all medicines out of reach of children.