Neomycin

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Contents

Introduction

A natural group of three aminoglycosides from Streptomyces fradiae isolated first in 1949 it is effective against both gram positive and gram negative bacteria. It has high human systemic toxicity.

Clinical Use

Poorly absorbed so widely used for gut sterilisation or topically.

Indications

Administration

Oral Topical

Clinical Issues

Class Contraindications

Class Side-effects

  • Ototoxicity
  • Nephrotoxicity
  • Impairment neuromuscular transmission

Aminoglycoside ototoxicity is associated with a genetic susceptibility in a third to a half of all cases. Most commonly mitochondrial – shows bacterial origin. Screening patients likely to need repeated courses eg CFs, chemotherapy patients, preterm neonates is feasible, but cost:benefit ratio? Consider costs of deafness, cochlear implant etc.

Class Interactions

  • Enhanced ototoxicity with ototoxic diuretics eg furosemide.

Special advice

Pharmacology

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