Neomycin, polymyxin B, and hydrocortisone (Otic)

Neomycin, polymyxin B, and hydrocortisone is an antibiotic that is used for the treatment of inner ear infections.

Overview

In the US, neomycin, polymyxin B, and hydrocortisone is known under the following brand names:

  • Pediotic
  • Oti-Sone
  • Cortomycin
  • Cortisporin
  • Cort-Biotic
  • Antibiotic Otic

The drug is a cortisone-antibiotic medication that is used in the treatment of infections affecting the mastoid cavity and the inner ear. The medicine can also be used to provide relief from irritation, reddening, and the discomfort that may be caused by certain ear conditions.

The medication is a prescription preparation that you will be given by your GP. It comes as a suspension or solution for use as ear drops.

Conditions treated

  • Inner ear infections
  • Mastoid cavity infections

Type of medicine

  • Antibiotic-cortisone combination
  • Ear drops
  • Solution
  • Suspension

Side effects

In addition to its desired effects, some drugs can cause a few unwanted side effects. Not all patients who are using neomycin, polymyxin B, and hydrocortisone will be affected, but if you do notice any odd effects, you may need to seek further medical advice.

If you notice any strange after-effects following use of this medication, check with your GP or pharmacist right away.

Dosage

Before you administer neomycin, polymyxin B, and hydrocortisone ear drops, you may wish to warm them slightly to body temperature to make their use more comfortable. You can do this by holding the container of ear drops in your hand for a few moments before application. However, you must not allow the drug to become too warm or the drug could break down, damaging its efficacy. Note that body temperature is 980F or 370C.

Guidelines for use:

1. Tilt your head or lie down so that the ear to be treated is uppermost.

2. When treating adults, carefully lift the earlobe and backwards. For children, pull the ear lobe down and back. This causes the ear canal to straighten.

3. Drop the prescribed number of ear drops into the inner ear. Wait for five minutes or so to enable the medication to thoroughly coat the ear canal.

4. Your GP may have placed a cotton or gauze wick into the ear. You may be instructed to moisten the wick with neomycin, polymyxin B, and hydrocortisone drops. If you have any questions about this, check with your GP.

5. It is important that you keep your ear as clean and free of bacteria as possible to allow the ear to heal properly. Do not allow the dropper to come into contact with any surface, including your fingers and your ear. Be sure to keep the contained firmly closed.

You must complete the full course of your treatment to ensure that the infection does not recur. Do not miss any doses, and do not stop using the medicine, even if you think your ear is better.

Dosage guidelines

The dose of neomycin, polymyxin B, and hydrocortisone that is prescribed will vary between individuals. You must use your ear drops in accordance with your doctor's directions or as per the instructions on the dispensary label. The information contained in this guide relates to the average dose only. If your dose is not the same as this, do not alter it unless you are instructed to do so by your GP.

Note that the size of the dose you should take, the frequency, and the duration of use of the drug will be dependent on the condition for which you are being treated and the strength of the product you have been prescribed.

To treat inner ear infections:

  • Adults: Apply four drops in the ear in three or four daily doses.
  • Children: Apply three drops in the ear in three or four daily doses.

To treat mastoid cavity infections:

  • Adults: Apply four to ten drops in the ear at six to eight hourly intervals.
  • Children: Apply four to five drops in the ear six to eight hourly intervals.

If you omit a dose of the medication, use it straight away. However, if your next dose is nearly due, leave that dose out and continue with your usual dosing regimen.

Interactions

Drug interactions

There are some drugs that should not be used together in any circumstances, as to do so could trigger an interaction between them. In some cases, two or more drugs can be used together, provided that steps are taken to prevent or manage the interactions. Be sure to advise your GP if you are already taking any other forms of medication, including over the counter products.

Do not use any other form of ear drops or ear medicines while you are using neomycin, polymyxin B, and hydrocortisone.

Other interactions

Some drugs should not be taken while you are using alcohol or tobacco, or if you are eating certain food groups. You should discuss this with your doctor before you start using neomycin, polymyxin B, and hydrocortisone.

Medical interactions

The presence of some pre-existing or historical health conditions can affect how neomycin, polymyxin B, and hydrocortisone works. You must not use this medication if you already have an existing ear condition or infection such as a punctured eardrum. Using this medication could make these conditions much worse.

Warnings

When agreeing to treatment with a particular medicine, you should consider the benefits of doing so versus the potential risks. In order to come to an informed decision, discuss the use of neomycin, polymyxin B, and hydrocortisone with your doctor. You may also wish to consider the following points:

Allergic reactions

You must remember to let your doctor know if you have ever noticed an odd reaction to neomycin, polymyxin B, and hydrocortisone or to any other form of medicine, including over the counter products. Mention also any allergies that you have to food colors, preservatives, certain food groups, and animal derivatives.

Pediatric

There has not been any specific research carried out into the use of neomycin, polymyxin B, and hydrocortisone in children. However, it is not expected that this medication would cause an issue or any side effects in juvenile patients. If you have concerns in this regard, check with your GP before using this drug to treat your child.

Geriatric

The effects of neomycin, polymyxin B, and hydrocortisone in the elderly age group has not been studied in isolation. However, there is nothing to suggest that the use of this preparation in geriatric patients could cause any side effects or other problems. However, if you have any questions or concerns in this area, you should ask your GP for more information.

Pregnancy and breastfeeding

As far as has been determined through studies carried out to date, using neomycin, polymyxin B, and hydrocortisone in women who are pregnant is safe and does not present any risk to the unborn baby. However, if this applies in your own case, you may wish to discuss using this medication with your GP if you are expecting a baby, or if you are planning on getting pregnant in the near future while using this drug.

There have been no studies to show that neomycin, polymyxin B, and hydrocortisone may be ingested by an infant that is being breastfed. If you are worried that your nursing infant could be affected by this drug during the course of your treatment, have a chat with your GP or midwife for more information on alternative feeding solutions.

Medical complications

If the symptoms of your ear infection do not begin to show improvement after a week's treatment with neomycin, polymyxin B, and hydrocortisone, or if they start to get worse, you must go back to your GP for further medical attention.

It is important that you do not use this drug for a period longer than 10 days unless your GP tells you to do so.

Storage

Keep your neomycin, polymyxin B, and hydrocortisone ear drops in their original container with the lid tightly sealed. Place the medicine away from sources of heat and out of direct sunlight.

Do not freeze the medicine.

Be sure to put your neomycin, polymyxin B, and hydrocortisone ear drops where children and pets cannot reach them. In the unlikely event that a pet does eat some of your medication, contact your vet for advice right away.

Do not use medicine that has become out-of-date. Ask your pharmacist for advice on the safe disposal of unwanted ear drops.

Summary

Neomycin, polymyxin B, and hydrocortisone is a prescription-only combination of antibiotic and cortisone. The ear drops formulation is used to treat inner ear and mastoid cavity infections.

This medicine is suitable for home use. It does not usually cause any adverse effects and can be safely used with most other medicines, aside from other ear drops. If your ear condition does not clear up after 10 days or so, you should refer to your doctor for more advice and an alternative treatment.