Neomycin 

Category:

  • Antibiotic

Description:

  • Aminoglycoside antibiotic

Indications:

  • Suppression of bowel intestinal bacteria

  • Hepatic coma

Contraindications:

  • Presence of intestinal obstruction

  • Generally not indicated for long-term therapy due to nephrotoxocity and ototoxicity

Precautions:

  • Pregnancy category D

  • May cause nephrotoxicity, therefore closely monitor renal function, especially in elderly patients.

  • May cause ototoxicity, therefore monitor hearing

  • Aminoglycosides have neuromuscular blockade activity with a curare-like effect.  Monitor patient’s neuromuscular function, especially in patients with myasthenia gravis, parkinsonism or infant botulism.

  • Used in combination for bowel surgery preparation (used with minimal diet, bisacodyl, magnesium sulfate, enema, and supplemental IV fluids)

Adverse Reactions (Side Effects):

  • Gastrointestinal: vomiting, nausea, anorexia

  • “Malabsorption syndrome” characterized by increase in fetal fat, decrease in serum carotene and fall in xylose absorption

  • Increases fecal bile acid excretion and reduces intestinal lactase activity

Dosage:

  • Administered orally

  • Hepatic coma:

    • Adults: 4-12 grams per day in divided doses

    • Children: 50-100mg/kg/day in divided doses for a period of 5-10 days

  • Bowel preparation:

    • 1 gram (in combination with 1 gram erythromycin) for three doses at time periods of time of actual surgery minus 19 hours (T-19), minus 18 hours (T-18) and minus 9 hours (T-9)

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