Neomycin/polymyxin B/bacitracin
Antibiotic medication
From Wikipedia, the free encyclopedia
Neomycin/polymyxin B/bacitracin, also known as triple antibiotic ointment, and sold under the brand name Neosporin, among others, is an antibiotic medication used to reduce the risk of infections following minor skin injuries.[1][2] It contains the three antibiotics neomycin, polymyxin B, and bacitracin.[1] It is for topical use.[3][4]
Squeeze tube of triple antibiotic ointment (marketed since 1952) | |
| Combination of | |
|---|---|
| Polymyxin B sulfate | Antibiotic |
| Neomycin sulfate | Antibiotic |
| Bacitracin zinc | Antibiotic |
| Clinical data | |
| Trade names | Neosporin, others |
| AHFS/Drugs.com | Multum Consumer Information |
| MedlinePlus | a601098 |
| License data | |
| Routes of administration | Topical, Ophthalmic drug administration |
| ATC code | |
| Legal status | |
| Legal status |
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| Identifiers | |
| CAS Number | |
| ChemSpider | |
| KEGG | |
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Possible side effects include itchiness and skin rash,[5] and in rare cases hearing loss.[5] It is relatively broad spectrum, being effective against both Gram-negative and Gram-positive bacteria.[2]
The combination is available over the counter in the US and Canada.[5] In 2023, it was the 367th most commonly prescribed medication in the United States, with more than 15,000 prescriptions.[6]
Medical uses
Neomycin/polymyxin B/bacitracin ointment is reported to be a safe and effective topical agent for preventing infections in minor skin trauma.[3]
It is used for burns, scratches, cuts, and minor skin infections.[7] The use of neomycin/polymyxin B/bacitracin, decreases infection rates in minor-contaminated wounds (hence for external use only[4]).[8]
Side effects
It has been shown to cause contact dermatitis in some cases.[9]
Antibiotic-resistant bacteria
Concern exists that its use contributes to the emergence of antibiotic-resistant bacteria (the US is the only large market for the ointment). For instance, it may increase the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) bacteria,[10] specifically the highly lethal ST8:USA300 strain.[11][12][13]
Components
The 2023 updated Johnson & Johnson Consumer Inc. label for their product discloses three different antibiotics: bacitracin zinc 400 units, neomycin sulfate 3.5 mg, and polymyxin B sulfate 5,000 units, in a relatively low-molecular-weight base of petroleum jelly, cottonseed oil, olive oil, and cocoa butter, and with sodium pyruvate and tocopheryl acetate.[14]
The generic name for these products, regardless of the base, is "triple antibiotic ointment". In China, this product (with lidocaine HCl) is named "FONOW® Ointment (孚诺®软膏, Compound Polymyxin B Ointment)"[15][16] and is exclusively manufactured and sold by Zhejiang Fonow Medicine Co. Ltd.[17] The product was also marketed by the Upjohn Company under the name "Mycitracin", until 1997 when that name was acquired by Johnson & Johnson.[18]
Some people have allergic reactions to neomycin, so a "double antibiotic ointment" is sold without it, containing only bacitracin and polymyxin B: one such example is Polysporin branded product.[medical citation needed]
A variant of Polysporin, called Polysporin Triple Ointment, replaces neomycin with gramicidin, providing an alternative for those allergic to neomycin while still offering broad-spectrum coverage against both Gram-negative and Gram-positive bacteria.[19]
Active ingredients
The three main active ingredients in Neosporin are neomycin sulfate, polymyxin B sulfate, and bacitracin zinc.[20][7]
One of the main components is neomycin sulfate, which is a type of antibiotic discovered in 1949 by microbiologist Selman Waksman at Rutgers University.[21] Neomycin belongs to the aminoglycoside class of antibiotics and fights against Gram positive and gram negative bacteria. The antibiotic is often used to prevent risk of bacterial infections.[22] Aminoglycosides work by binding to bacterial RNA and changing the ability to produce proteins while exerting little to no effect on DNA. Thus, neomycin kills bacteria as a result of irregular protein production in the bacterial cell. When the cell can no longer produce the correct proteins, its membrane becomes damaged.[23] As a result of damaged membrane, the affected bacterial cells die, and the infection is prevented or limited.[medical citation needed]
Pramoxine is used to temporarily reduce pain from burns, insect bites, and minor cuts. It works like an anesthetic by decreasing the permeability of neuron membranes. As a result, pain neurons in the area have difficulty sending signals (or signals are blocked entirely), resulting in numbness.[24]
In some countries bacitracin is replaced with gramicidin.[25] The original Neosporin contained this combination.[26]
