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Neomycin is an aminoglycoside antibiotic produced by Streptomyces fradiae. Neomycin is a broad-spectrum antibiotic. It is active against gram-negative and gram-positive bacteria.

How neomycin works

The bactericidal mechanism of action of this well-known antibiotic is binding to the 30S ribosome subunit, which leads to mRNA misreading during the translation process, resulting in the synthesis of abnormal proteins and the death of the bacterial cell. Neomycin is a broad-spectrum antibiotic. It is active against gram-negative bacteria (including Escherichia coli, Enterobacter aerogenes, Klebsiella pneumoniae, Salmonella spp., Haemophilus influenzae, Neisseria meningitidis) and gram-positive bacteria (Staphylococcus aureus, Streptococcus faecalis, Listeria monocytogenes, Mycobacteriumerculosis).

Orally administered neomycin is absorbed from the gastrointestinal tract in about 3%. It reaches high concentrations in the intestines. The absorbed part of the drug is excreted in the urine, and the remaining, unabsorbed antibiotic (approximately 97%) is excreted unchanged in the faeces.

Most gut bacteria are inhibited by neomycin in approximately 72 hours. After topical application (aerosol, eye ointment), neomycin can be absorbed into the circulatory system only in the event of tissue damage.

Indications for the use of neomycin

Neomycin tablets are mainly used to sterilize the gastrointestinal tract prior to intestinal surgery. The aerosol is used in purulent skin diseases, infected, minor burns and frostbites. Eye ointment is used in bacterial inflammation of the conjunctiva or the edges of the eyelids.

Contraindications to the use of neomycin

Hypersensitivity to neomycin or other aminoglycoside antibiotics or any of the excipients, intestinal ulceration or obstruction, hearing impairment, myasthenia gravis.

Available preparations

Neomycin is available as oral tablets, skin spray, eye ointment, but also as one of the constituent eye and ear drops.

Neomycin dosage

Dosage depends on the form and indications. They are determined individually by a doctor. In the case of treatment with neomycin, particular care should be taken not to do soexceed the necessary treatment time.

Neomycin side effects

Depending on the form of the drug, these may be fungal infections of the skin and mucous membranes, superinfections with resistant bacteria, abnormal blood composition, haemolytic anemia. Due to the ototoxic and nephrotoxic effects of the drug, patients taking oral neomycin should be closely monitored. Preterm infants, newborns, patients with renal impairment and elderly patients are the most sensitive to the toxic effects of neomycin.

In these patients it is recommended to determine the dose of neomycin individually, based on its concentration in blood. This recommendation should also be followed in overweight or cystic fibrosis patients. In patients with impaired renal function, it is necessary to reduce the dose of the antibiotic.

Aminoglycosides, regardless of the route of administration, may cause neuromuscular blockade. Particular caution should be exercised in patients with neuromuscular diseases and parkinsonism. Topical neomycin causes very rarely the side effects of aminoglycoside antibiotics.

Interaction with other drugs

Orally administered neomycin reduces the absorption of phenoxymethylpenicillin, methotrexate, digoxin, vitamin A and vitamin B12.

Simultaneous administration with neomycin of ethacrynic acid, furosemide and other medicinal products with nephrotoxic properties (e.g. other aminoglycosides, some cephalosporins, amphotericin, cyclosporin, teicoplanin, vancomycin) or ototoxic (e.g. , products containing platinum) intensifies its oto- and nephrotoxic effects.

Concomitant administration of neomycin with muscle relaxants (e.g. botulinum toxin) or neuromuscular inhibitors (e.g. inhaled anesthesia, opioid analgesics) increases neuromuscular blockade, which can even lead to apnea.

Aminoglycosides may reduce the effect of parasympathomimetic products (e.g. neostigmine, pyridostigmine).

Aminoglycosides used concomitantly with bisphosphonates may increase the risk of hypocalcaemia. Neomycin may reduce the effectiveness of oral contraceptives.

Effect on pregnancy and lactation

Neomycin crosses the placental barrier and may damage the fetal kidneys. The child's hearing may also be damaged. Aminoglycoside antibiotics are excreted in milk in small but quantifiable amounts.

In infants who are breastfedSerious side effects may occur by mothers treated with aminoglycosides, therefore breastfeeding should be discontinued during the use of neomycin.

Effects on the ability to drive and use machines

There are no data on the adverse effects of the drug on the ability to drive and use machines.

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Intimate diseases