Hydrocortisone/neomycin/polymyxin
Administration
- Type: topical antibiotic/steroid
- Dosage Forms: 3.5 mg/10,000 units/10 mg per mL
- Routes of Administration: topical, otic
- Common Trade Names: Cortisporin otic
Adult Dosing
- 4 drops in ear q6-8hr
- Max: 10 days
Pediatric Dosing
- 3 drops in ear q6-8hr
- Max: 10 days
Special Populations
- Pregnancy Rating: Category C
- Lactation risk: Unknown whether drug is excreted in milk; use with caution
Renal Dosing
- Adult: n/a
- Pediatric: n/a
Hepatic Dosing
- Adult: n/a
- Pediatric: n/a
Contraindications
- Allergy to class/drug
- Cutaneous viral infection of the external auditory canal (e.g. patients with herpes simplex, vaccinia, and varicella infections)
Adverse Reactions
Serious
- Ototoxicity
- Neomycin sensitization with itching, reddening, edema, and failure to heal
- Systemic absorption of topical corticosteroids--> HPA axis suppression --> adrenal crisis
- Prolonged use of corticosteroids may lead to increase incidence of infection, masking of infection, limited response to vaccines
- Prolonged use of corticosteroids associated with development of Kaposi sarcoma
Common
- Itching
- Redness
- Rash
- Swelling
Mechanism of Action
- Hydrocortisone: Suppresses inflammatory response
- Polymyxin: disrupts bacterial cytoplasmic membrane permeability allowing leakage of intracellular contents--> bactericidal
- Neomycin: Inhibits protein synthesis