Polymyxin B-bacitracin

Unlike dendritic keratitis, indolent ulcers are typically very difficult to treat. Instillation of a prophylactic antibiotic, such as polymyxin B-bacitracin ointment two to four times a day, and a cycloplegic agent, such as 5% homatropine two to three times a day, is indicated. Therapeutic soft contact lens use with appropriate antibiotic therapy can also be considered as alternatives. These patients must be monitored carefully to ensure that no secondary infection develops. If the ulcer deepens, a new infiltrate forms, or if there is an increase in the anterior chamber reaction while the patient is being treated, cultures should be performed to rule out bacterial or fungal infection. Cyanoacrylate glue, conjunctival flap surgery, or tarsorrhaphy may be required if healing does not occur. 

A 65-year-old man undergoing elective sternal debridement and rewiring was given a prophylactic infusion of vancomycin 1 g preoperatively. Anesthesia was induced with thiopental, suxamethonium, and fentanyl, and maintained with fentanyl, vecuronium, and isoflurane. A few minutes after wound irrigation with bacitracin (about 25U/ml), his blood pressure fell precipitously, necessitating intravenous fluids and adrenaline. His face and arms were flushed. Afterwards, he reported having had a rash several years before after the use of an over-the-counter ointment composed of polymyxin B, bacitracin, and neomycin. 

The polypeptides include bacitracin A, colistin (polymyxin E), novobiocin, and polymyxin B. Bacitracin is a complex mixture of branched, cyclic decapeptides produced by Bacillus subtilise, which was first isolated in 1945. The polymyxins, discovered in 1947, are synthesized by various strains of Bacillus polymyxa. Colistin (polymyxin E) comprises a family of polymyxins and was known as colimycin when first isolated from a broth of Bacillus polymyxa var. colistinus in 1951. The polymyxins are cationic detergents. Novobiocin, first reported in 1955 as streptonivicin, is produced by the actinomycete Streptomyces niveus. 

Most polymyxin B sold for human use in the United States is in dermatological, otic, and ophthalmic preparations that usually contain one or more other spectmm extending antibacterials such as bacitracin, neomycin sulfate [1404-04-2], C23H4gNg023, linear gramicidin, oxytetracycline [79-57-2],... 

Although tyrothricia is too toxic for parenteral therapy, it was formerly sold in the United States as oral lo2enges. Modem tyrothricin formulations are composed of 70—80% tyrocidines and 30—20% linear gramicidins. Tyrocidines are not as active as linear gramicidins and are too toxic for any therapeutic use by themselves. The bactericidal linear gramicidins are used in the United States solely as an ophthalmic solution in combination with polymyxin B sulfate and neomycin sulfate. The linear gramicidin is used in this aqueous product as a substitute for bacitracin, which lacks stabiUty under such conditions. 

AK-Fbly-Bac Ophthalmic Ointment—polymyxin B sulfate, bacitracin zinc... 

Polypeptides Bacitracin, colistin, and polymyxin B Eye, ear, or bladder infections... 

Systemic therapy with a variety of (3-lactams, macro-lides and lincosamides (clindamycin) has been the cornerstone of skin infection therapy for many years [17]. However, topical antibiotics can play an important role in both treatment and prevention of many primary cutaneous bacterial infections commonly seen in the dermatological practice [18], Indeed, while systemic antimicrobials are needed in the complicated infections of skin and skin structure, the milder forms can be successfully treated with topical therapy alone [18], The topical agents used most often in the treatment of superficial cutaneous bacterial infections are tetracyclines, mupirocin, bacitracin, polymyxin B, and neomycin. 

Bacitracin Polymyxin B, Topical (Polysporin) Bacitracin, Neomycin, Polymyxin B, Topical (Neosporin Ointment) Bacitracin, Neomycin, Pol5rm5 xm B, Hydrocortisone, Topical (Cortisporin)... 

Bacitracin, Neomycin, Polymyxin B, Lidocaine, Topical (Clomycin)... 

Neomycin is often combined with other antibiotics, such as polymyxin B and bacitracin, and applied as an ointment to prevent any infection of minor skin abrasions, burns, and cuts. 

C) Triple antibiotics (bacitracin, Polymyxin B, and neomycin) ointment... 

Rx with chloramphenicol (Chloromycetin/HC suspension—ophthalmic) with neomycin and polymyxin B (Cortisporin Otic, Drotic, Otocort—otic) with neomycin, polymyxin B, and bacitracin (Cortisporin Ointment, Neotricin HC—ophthalmic) with oxytetracycline (Terra-Cortril—ophthalmic) with urea (Carmol HC)... 

Various antibiotics bacitracin chloramphenicol colistimethate sodium fosfomycin tromethamine fusidic acid metronidazole polymyxin B sulfate rifabutin sodium fusidate... 

Bacitracin, polymyxin B sulphate, neomycin, gentamicin, gramicidin, mupirocin (T-BACT)... 

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