IN VITRO INTERACTIONS OF NEOMYCIN SULFATE, BACITRACIN, AND POLYMYXIN B SULFATE

BOOTH, JH; BENRIMOJ, SI; NIMMO, GR

IN VITRO INTERACTIONS OF NEOMYCIN SULFATE, BACITRACIN, AND POLYMYXIN B SULFATE

BOOTH, JH BENRIMOJ, SI

NIMMO, GR

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Publication Type:: Journal Article
Citation:: International Journal of Dermatology, 1994, 33 (7), pp. 517 - 520
Issue Date:: 1994-01-01

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Field	Value	Language
dc.contributor.author	BOOTH, JH	en_US
dc.contributor.author	BENRIMOJ, SI https://orcid.org/0000-0001-9768-7838	en_US
dc.contributor.author	NIMMO, GR	en_US
dc.date.issued	1994-01-01	en_US
dc.identifier.citation	International Journal of Dermatology, 1994, 33 (7), pp. 517 - 520	en_US
dc.identifier.issn	0011-9059	en_US
dc.identifier.uri	http://hdl.handle.net/10453/21977
dc.description.abstract	Background. Neomycin sulfate, bacitracin, and polymyxin B sulfate have been combined in topical preparations to provide a complementary antimicrobial spectrum for the prevention of minor wound infections. The advisability of the inclusion of neomycin sulfate has been questioned since it may cause contact sensitization. Methods. To assess the value of neomycin, microdilution checkerboard titrations were used to determine the in vitro interactions between two‐antibiotic and three‐antibiotic combinations against reference strains of bacteria commonly associated with wound infections. Using Fractional Inhibitory Concentration (FIC) indices (< 0.5 indicates synergism with two‐drug combinations), the combination of neomycin/bacitracin was synergistic for both S. aureus and Ps. aeruginosa; neomycin/polymyxin B was synergistic for E. faecalis, and the bacitracin/polymyxin B combination was synergistic against Ps. aeruginosa. A three‐drug combination of neomycin/bacitracin/polymyxin B had FIC values of < 1 for all organisms, indicating synergy and substantiating the clinical role of neomycin sulfate in current topical formulations. Results. Neomycin has the lowest safety profile of the drugs in this combination. A replacement agent should ideally have similar or superior synergistic capabilities with the remaining drugs and contribute to the therapeutic efficacy of the preparation. Additionally, because of the strongly synergistic tendencies displayed by the three‐drug combination, it may be possible to reduce the antibiotic concentrations present in current formulations. Conclusion. By developing this concept, there is potential for the formulation of topical preparations to be based on a sound theoretical and clinical rationale. Copyright © 1994, Wiley Blackwell. All rights reserved	en_US
dc.relation.ispartof	International Journal of Dermatology	en_US
dc.relation.isbasedon	10.1111/j.1365-4362.1994.tb02872.x	en_US
dc.subject.classification	Dermatology & Venereal Diseases	en_US
dc.subject.mesh	Pseudomonas aeruginosa	en_US
dc.subject.mesh	Escherichia coli	en_US
dc.subject.mesh	Proteus vulgaris	en_US
dc.subject.mesh	Staphylococcus aureus	en_US
dc.subject.mesh	Bacitracin	en_US
dc.subject.mesh	Polymyxin B	en_US
dc.subject.mesh	Neomycin	en_US
dc.subject.mesh	Drug Combinations	en_US
dc.subject.mesh	Microbial Sensitivity Tests	en_US
dc.subject.mesh	Sensitivity and Specificity	en_US
dc.subject.mesh	Drug Interactions	en_US
dc.title	IN VITRO INTERACTIONS OF NEOMYCIN SULFATE, BACITRACIN, AND POLYMYXIN B SULFATE	en_US
dc.type	Journal Article
utslib.citation.volume	7	en_US
utslib.citation.volume	33	en_US
utslib.for	1103 Clinical Sciences	en_US
utslib.for	1117 Public Health and Health Services	en_US
dc.location.activity	ISI:A1994NU75100020	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Graduate School of Health
utslib.copyright.status	closed_access
pubs.issue	7	en_US
pubs.publication-status	Published	en_US
pubs.volume	33	en_US

Abstract:

Background. Neomycin sulfate, bacitracin, and polymyxin B sulfate have been combined in topical preparations to provide a complementary antimicrobial spectrum for the prevention of minor wound infections. The advisability of the inclusion of neomycin sulfate has been questioned since it may cause contact sensitization. Methods. To assess the value of neomycin, microdilution checkerboard titrations were used to determine the in vitro interactions between two‐antibiotic and three‐antibiotic combinations against reference strains of bacteria commonly associated with wound infections. Using Fractional Inhibitory Concentration (FIC) indices (< 0.5 indicates synergism with two‐drug combinations), the combination of neomycin/bacitracin was synergistic for both S. aureus and Ps. aeruginosa; neomycin/polymyxin B was synergistic for E. faecalis, and the bacitracin/polymyxin B combination was synergistic against Ps. aeruginosa. A three‐drug combination of neomycin/bacitracin/polymyxin B had FIC values of < 1 for all organisms, indicating synergy and substantiating the clinical role of neomycin sulfate in current topical formulations. Results. Neomycin has the lowest safety profile of the drugs in this combination. A replacement agent should ideally have similar or superior synergistic capabilities with the remaining drugs and contribute to the therapeutic efficacy of the preparation. Additionally, because of the strongly synergistic tendencies displayed by the three‐drug combination, it may be possible to reduce the antibiotic concentrations present in current formulations. Conclusion. By developing this concept, there is potential for the formulation of topical preparations to be based on a sound theoretical and clinical rationale. Copyright © 1994, Wiley Blackwell. All rights reserved

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http://hdl.handle.net/10453/21977