Neomycin (topical)
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Neomycin is an aminoglycoside antibiotic that is found in many topical medications such as creams, ointments and eyedrops.
Category
Aminoglycoside
US Brand Names
NEO-FRADIN®
FDA Package Insert
Description | Clinical Pharmacology | Microbiology | Indications and Usage | Contraindications | Warnings and Precautions | Adverse Reactions | Drug Interactions | Overdosage | Dosage and Administration | How Supplied | Labels and Packages
Mechanism of Action
Neomycin irreversibly bind to 30S subunit proteins and 16S rRNA. Specifically neomycin binds to four nucleotides of 16S rRNA and a single amino acid of protein S12. This interferes with the formation of the initiation complex and leads to misreading of mRNA.
Historical Perspective
Neomycin was discovered in 1949 by the microbiologist Selman Waksman and his student Hubert Lechevalier. It is produced naturally by the bacterium Streptomyces fradiae.
Uses
Neomycin is overwhelmingly used as a topical preparation. It can also be given orally, where it is usually combined with other antibiotics. Neomycin is not absorbed from the gastrointestinal tract, and has been used as a preventative measure for hepatic encephalopathy and hypercholesterolemia. By killing bacteria in the intestinal tract, it keeps ammonia levels low and prevents hepatic encephalopathy, especially prior to GI surgery. It has also been used to treat small intestinal bacterial overgrowth. It is not given intravenously, as neomycin is extremely nephrotoxic (causes kidney damage), especially compared to other aminoglycosides. The exception to this, is when it is included in some vaccines as a preservative, but in very small quantities -typically 0.025 mg per dose.[2]
Spectrum
Similar to other aminoglycosides, neomycin has excellent activity against Gram negative bacteria, and has partial activity against Gram positive bacteria. It is relatively toxic to humans, and some people have allergic reactions to it.[1]
Neomycin is used in the laboratory on agar plates to grow mutant forms of bacteria that carry genes for resistance to neomycin. The resistant genes to neomycin are found within the plasmid of the bacteria; which may or may not be incorporated into the bacteria's circular chromosome.