cortisol/neomycin/polymixin-B (Corticosporin, Cortisporin, Cortomycin)

Introduction

Topical agent

Ophthalmic agent: Tradename AK-spore HC.

Corticosporin otic.

Indications

Ophthalmic

• inflammatory ocular condition
  • corticosteroid indicated
  • bacterial infection of risk of bacterial infection

Otic

• treatment of superficial bacterial infection of the external auditory canal
• associated inflammatory response

Contraindications

• Herpes simplex
• Vaccinia
• Varicella

pregnancy-category C

safety in lactation ?

Dosage

Topical: Apply cream/ointment BID/TID.

Ophthalmic

• ointment or 1 drop suspension every 3-4 hours or BID-QID

Otic

• 4 drops TID-QID

Ointment: (ophthalmic)

• neomycin, polymixin B, hydrocortisone 1%

Suspension: (ophthalmic)

• neomycin, polymixin B, hydrocortisone 1% Solution (otic)
• neomycin sulfate 5 mg, polymixin B sulfate 10,000 units, hydrocortisone acetate 10 mg/mL (10 mL) Suspension (otic)
• neomycin sulfate 5 mg, polymixin B sulfate 10,000 units, hydrocortisone acetate 10 mg/mL (10 mL)

Cream: neomycin sulfate 5 mg, polymixin B sulfate 10,000 units, hydrocortisone acetate 5 mg/g (7.5 g)

Antimicrobial activity

• Streptococcus
• Staphylococcus
• Anaerobic cocci
• Corynebacterium
• Clostridium
• Neisseria gonorrhoeae
• Neisseria meningitidis
• E. coli
• H. influenzae
• Klebsiella
• Moraxella lacunata
• Proteus
• Serratia
• Pseudomonas
• E. aerogenes
• Fusobacterium
• Actinomyces israelii
• Treponema pallidum
• Treponema vincenti

Adverse effects

• common (> 10%)
  • hypersensitivity
• less common (1-10%)
  • contact dermatitis, erythema, rash, urticaria, burning, neuromuscular blockade, ototoxicity, nephrotoxicity, bladder irritation
• other
  • itching
  • irritation
  • neomycin is a contact sensitizer
  • apnea

Ophthalmic

• local irritation
• increased intraocular pressure
• glaucoma

More general terms

• antibiotic-glucocorticoid combination

Components

• cortisol; hydrocortisone (Cortef, Solu-Cortef, Alphaderm, Cetacort, Cortenema, Nutracort)
• neomycin (Mycifradin)
• polymixin B (Aerosporin)