Gentamicin topical

Dibucaine (Nupercainal) Doxepin, Topical (Zonalon, Prudoxin) Econazole (Spectazole) Efalizumab (Raptiva) Erythromycin, Topical (A/T/S, Eryderm, Erycette, T-Stat) Erythromycin Benzoyl Peroxide (Benzamycin) Finasteride (Propecia) Fluorouracil, Topical [5-FU] (Efudex) Gentamicin, Topical (Garamycin, G-Mycitin)... 

Topical antibiotics exert a direct local effect on specific microorganisms and may be bactericidal or bacteriostatic. Bacitracin (Baciguent) inhibits the cell wall synthesis. Bacitracin, gentamicin (G-myticin), erythromycin (Emgel), and neomycin are examples of topical antibiotics. These drugp are used to prevent superficial infections in minor cuts, wounds, skin abrasions, and minor burns. Erythromycin is also indicated for treatment of acne vulgaris. 

Docusate sodium is a preparation used for softening ear wax before removal. Hydrocortisone is a corticosteroid, whereas gentamicin, neomycin and clioquinol are antibacterial agents. Otitis externa may be managed by the use of antibacterial preparations used alone or in combination with topical corticosteroids. 

Gentamicin is an aminoglycoside. As aminoglycosides are not absorbed from the gastrointestinal tract, gentamicin is only presented for parenteral or topical use (as eye/ear drops). 

Blepharitis is a topical inflammation of the eyelid margins that should be treated using topical antibacterial agents. Gentamicin eye ointment is preferred to the fusidic acid drops since the ointment is a better formulation to be used where the condition involves the eyelid margins. Chloramphenicol eye drops is the third option since it is an antibiotic with a wider spectrum of activity. A combination of corticosteroid and antibiotic is not recommended because of the side-effects associated with the steroid. The use of oral tablets is not usually recommended since blepharitis can easily be managed with topical drops. The use of dexamethasone eye drops, monotherapy steroid, could clear the inflammation but mask persistence of infection. 

If giving topical gentamicin, monitor the patient for itching and redness... 

Creams, ointments, and solutions containing 0.1-0.3% gentamicin sulfate have been used for the treatment of infected burns, wounds, or skin lesions and the prevention of intravenous catheter infections. Topical gentamicin is partly inactivated by purulent exudates. Ten mg can be injected subconjunctivally for treatment of ocular infections. 

Neomycin is available in numerous topical formulations, both alone and in combination with polymyxin, bacitracin, and other antibiotics. It is also available as a sterile powder for topical use. Gentamicin is available as an ointment or cream. 

Topical application of neomycin rarely results in detectable serum concentrations. However, in the case of gentamicin,... 

Neomycin is particularly ototoxic and nephrotoxic when given parenterally. As with gentamicin and kanamycin, the nephrotoxicity may be reversible but the ototoxicity is usually irreversible and deafness may occur following oral administration, instillation into cavities, or topical use. It may block neuromuscular action and respiratory depression has been reported. Local treatments may cause hypersensitivity, rashes, pruritus, and anaphylaxis. Neomycin is not geno-toxic. 

Transcorneal iontophoresis of antibiotics for the treatment of corneal ulcers offers a potentially effective method of management. Numerous studies have demonstrated successful penetration of antibiotics into the anterior chamber after iontophoretic treatment, compared with topically eyedrop instillation of the drug [42,58,59,66,67], The efficacy of the treatment was investigated in rabbit eyes after intrastromal injection of Pseudomonas. Gentamicin, tobramycin, and ciprofloxacin iontophoresis resulted in significantly fewer bacterial colonies in the cornea compared with frequent eyedrops instillation [68-71],... 

Topical application of neomycin rarely results in detectable serum concentrations. However, in the case of gentamicin, serum concentrations of 1-18 g/mL are possible if the drug is applied in a water-miscible preparation to large areas of denuded skin, as in burned patients. Both drugs are water-soluble and are excreted primarily in the urine. Renal failure may permit the accumulation of these antibiotics, with possible nephrotoxicity, neurotoxicity, and ototoxicity. 

Leliever WC. Topical gentamicin-induced positional vertigo. Otolaryngol Head Neck Surg 1985 93(4) 553-5. 

Disposition in the Body. Poorly absorbed after oral administration but rapidly absorbed after intramuscular injection it is also absorbed systemically following topical application to wounds. In normal subjects it is rapidly excreted in the urine as unchanged drug, up to 80% of a dose being excreted in 24 hours. It accumulates in the tissues and there may be considerable intersubject variation in the pharmacokinetics. Gentamicin may be detected in serum and urine for several days after cessation of treatment. 

Acute mucopurulent Gentamicin, tobramycin, trimethoprim/polymyxin B, ciprofloxacin, norfloxacin, ofloxacin, levofloxacin, gatifloxacin, or moxifloxacin Topical... 

Large Fortified cefazoUn and gentamicin or tobramycin Topical... 

Topical dermatologic preparations of gentamicin are commonly used for the treatment of infected burns. Topical ophthalmic gentamicin (see Table 11-5) is used to treat a variety of bacterial infections of the external eye and adnexa (e.g., conjunctivitis, blepharitis, and keratoconjunctivitis). 

Tobramycin is available as a topical ophthalmic solution and an ointment (see Table 11-5). Tobramycin is also prepared as a topical fortified solution for the treatment of corneal ulcers and is used in place of fortified gentamicin using the same dosage schedule (see Table 11-1). 

Side effects produced by topical gentamicin or tobramycin are imcommon but can include corneal and conjunctival toxicity. Punctate epithelial erosions, delayed reepithelialization, and corneal ulceration characterize this corneal toxicity, whereas chemosis, hyperemia, and necrosis characterize conjimctival toxicity. Allergic reactions to topical gentamicin occur infrequently, but approximately 50% of patients who are allergic to neomycin are also allergic to gentamicin. 

Neomycin is a topical aminoglycoside widely nsed for skin wounds and in otolaryngology. Its antibacterial activity resembles that of gentamicin and tobramycin, except that P aeruginosa, S. pneumoniae, and the a-hemolytic streptococci are generally resistant. Neomycin s usefnl-ness for treating acnte bacterial conjunctivitis is limited... 

If a significant inflammatory component or a response to bacterial exotoxin hypersensitivity in the fiarm of marginal corneal infiltrates or phlyctenules is present, treatment may require concurrent topical steroid therapy. When chronic dacryocystitis is involved, treatment should include irrigation of the lacrimal system with trimethoprim-polymyxin B or gentamicin. Adjunctive systemic antibiotic therapy may also be required (see Chapter 24). 

Initial treatment of bacterial ophthalmia neonatorum should be directed by the results of conjimctival smears. Broad-spectrum antibiotics with low toxicity should be used. Topical erythromycin or tetracycline ointment can be used four to six times daily fc>r gram-positive organisms, and gentamicin or tobramycin solution four to six times daily can be started if gram-negative organisms are isolated. Trimethoprim-polymyxin B (Polytrim) has... 

Although topical antibiotics are used frequently in the management of ocular rosacea, no firm evidence demonstrates their efficacy as a sole therapeutic agent. Topical steroids, however, are effective for treating the inflammatory aspects and frequently are used four times daily in conjimction with antibiotics in combination products such asTobraDex (tobramycin-dexamethasone), Pred-G (gentamicin-prednisone), or Maxitrol (neomycin-polymyxin B-dexamethasone). Because of potential steroid-induced side effects, chronic use of these agents should be avoided. 

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