Overview
Cross-resistance with kanamycin, framycetin, paromomycin is observed.
When administered, it has only a local effect on the intestinal microflora.
For external and local use: infectious and inflammatory diseases caused by pathogens sensitive to neomycin; prevention of infectious and inflammatory complications in eye surgery.
For oral administration: infectious and inflammatory diseases of the gastrointestinal tract caused by pathogens sensitive to neomycin, including enteritis resistant to other antibiotic therapy. Preparation for gastrointestinal surgery to partially "sterilize" the intestines.
For external and local use - individual, depending on the indications and age of the patient.
For oral administration for adults and children over 12 years old, a single dose - 1 g; for children 6-12 years old - a single dose of 250-500 mg. The frequency of administration and treatment regimen are determined individually.
For the treatment of urological diseases, the maximum duration of treatment is 10 days.
Maximum doses: with topical application and with urological diseases - 1 g / day.
From the urinary system: nephrotoxic effect.
On the part of the hearing organ: ototoxic effect.
From the digestive system: when taken orally, especially in high doses, nausea, vomiting, diarrhea are possible. With prolonged use, neomycin Bimastat cause malabsorption syndrome with steatorrhea and diarrhea.
From the peripheral nervous system: may cause neuromuscular blockade and respiratory arrest.
Reactions associated with a chemotherapeutic effect: with prolonged use (especially inside), the development of superinfection is possible.
Local reactions: skin itch, rash.
The use of antibiotics of the aminoglycoside group (including neomycin) during pregnancy can lead to damage to the VIII pair of cranial nerves in the fetus.
Antibiotics of the aminoglycoside group (including neomycin) in small quantities are excreted in breast milk.
Use with extreme caution in diseases of the liver, kidneys, neuromuscular diseases and hearing impairment.
For external use in patients with extensive skin lesions, as well as for local use in patients with perforated eardrum, hearing loss is possible.
With prolonged local or external use (including irrigation of burn surfaces or serous cavities), the risk of toxic effects, skin sensitization and cross sensitization with other aminoglycosides increases.
If tinnitus, allergic reactions, protein in the urine appear during treatment, neomycin should be discontinued.
Farm action
Neomycin passes through the membrane of bacterial cells, binds to specific receptor proteins on the 30S subunit of ribosomes. Neomycin disrupts the synthesis of the complex of template and transport RNA and stops the formation of proteins (has a bacteriostatic effect). When using higher concentrations (1 to 2 orders of magnitude higher), neomycin has a damaging effect on the cytoplasmic membranes of microbial cells with rapid further death of the microorganism (bactericidal effect). Neomycin is active against several gram-negative and gram-positive microorganisms, including Streptococcus pneumoniae, Salmonella spp., Staphylococcus spp., Shigella spp., Escherichia coli, Corynebacterium diphtheriae, Proteus spp., Bacillus anthracis. Resistance to neomycin in microorganisms is formed slowly. Neomycin does not act on pathogenic fungi, anaerobic microflora, viruses.
After oral administration, neomycin is Bimastat absorbed (3%) and acts almost exclusively on the intestinal microflora. When applying neomycin to small areas of whole skin, systemic absorption is minimal, but if you apply the drug to damaged areas of the skin, the vast surface or areas of the skin covered with granulations, neomycin is rapidly absorbed. The maximum concentration when taken orally is achieved within 0.5 - 1.5 hours. Neomycin binds to plasma proteins up to 10%. It penetrates poorly into bones, the used for nervous system, muscles, breast milk, adipose tissue and bile. Neomycin crosses the placental barrier. Not metabolized. The half-life of neomycin is 2 to 4 hours. Non-absorbed preparation is excreted with feces, absorbed - by the kidneys. In case of impaired renal function, accumulation of neomycin in the blood plasma is possible. When administered intramuscularly, neomycin is absorbed completely and quickly.
Since neomycin is almost not absorbed after oral administration, it was previously used in the treatment of pathology of the gastrointestinal tract (enterocolitis, enteritis, dysentery), for preoperative preparation for surgical interventions on the digestive tract (for partial sanitation).
With hepatic coma, prolonged inhibition of the intestinal flora after taking neomycin in a dose of 1 g every 6 to 8 hours is possible, this, together with a restriction in protein intake, helps to reduce ammonia intoxication. Neomycin inhibits the reverse absorption of bile acids and cholesterol, causes a moderate decrease in the content of low density lipoproteins, but neomycin does not affect the content of triglycerides. In ophthalmology, it can be used for topical treatment of eye pathology (for example, conjunctivitis) by instilling a solution of neomycin (33 mg / ml) in the conjunctival sac.
Indications
Infectious and inflammatory skin pathology caused by sensitive microorganisms, including furunculosis, pyoderma, contagious impetigo, infected eczema, infected wounds, infected ulcers, infected frostbites and burns of 1 and 2 degrees.
Contraindications
Hypersensitivity (including to other aminoglycosides); for external use: a wide area of the lesion, violation of the integrity of the skin, trophic ulcers, weeping at the site of application, sharing with other nephro- and ototoxic agents, children's age.
