What is Cortisporin (neomycin and polymyxin B sulfates and hydrocortisone)?

From the Guidelines

Cortisporin should be used with caution in patients with a history of allergic reactions, especially to neomycin, due to the risk of contact dermatitis and allergic reactions, as reported in studies 1, 2. When using Cortisporin for ear infections, it is essential to follow the prescribed dosage and administration instructions to minimize the risk of adverse reactions. The typical dosage for Cortisporin otic suspension is 3-4 drops in the affected ear(s) three to four times daily for 7-10 days. Some key points to consider when using Cortisporin include:

• The medication contains neomycin, which can cause contact sensitivity in some patients, with a prevalence of 13% to 30% on patch testing of patients with chronic otitis externa 1.
• Patients with a history of allergic reactions or sensitive skin should be monitored closely for signs of contact dermatitis or allergic reactions, such as erythema, pruritus, or skin inflammation.
• If symptoms worsen or do not improve after a few days of treatment, patients should contact their healthcare provider to reassess the diagnosis and treatment plan.
• Cortisporin should not be used if the eardrum is perforated, as this can increase the risk of further complications. The antibiotic components in Cortisporin, including neomycin and polymyxin B, work by disrupting bacterial cell membranes and inhibiting protein synthesis, effectively killing a broad spectrum of bacteria. The hydrocortisone component reduces redness, swelling, and discomfort. It is crucial to complete the full course of treatment, even if symptoms improve quickly, to prevent recurrence or antibiotic resistance. In cases where Cortisporin is not effective or causes adverse reactions, alternative treatments may be necessary, such as topical antifungal medications or topical anti-inflammatory medications. Overall, Cortisporin can be an effective treatment for bacterial infections of the ear, skin, or eyes, but it is essential to use it judiciously and monitor patients closely for potential adverse reactions, as reported in studies 1, 2.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Cortisporin Overview

• Cortisporin is a type of antibiotic ointment that contains neomycin, polymyxin B, and bacitracin.
• It has been used to prevent superficial wound infections since the 1950s in the United States and is available over-the-counter (OTC) in the US, but is restricted to prescription use in Australia 3.

Antimicrobial Activity

• Studies have shown that Cortisporin has a wide spectrum of activity against various bacterial strains, including Staphylococcus aureus, coagulase-negative staphylococci (CoNS), Pseudomonas aeruginosa, and Enterobacteriaceae 3.
• The ointment has been found to be effective against methicillin-resistant Staphylococcus aureus (MRSA) and mupirocin-resistant strains 3.
• Neomycin, a component of Cortisporin, has been shown to have synergistic effects when combined with other antibiotics, such as bacitracin and polymyxin B 4.

Comparison with Other Antibiotics

• Cortisporin has been compared to other antibiotics, such as mupirocin, and has been found to have a wider spectrum of activity 3.
• The combination of neomycin with other antibiotics, such as ampicillin and procaine penicillin, has been found to have additive effects, but no synergy 4.
• Other studies have compared the efficacy of oral cephalosporins, such as cefaclor and cefuroxime axetil, to amoxicillin-clavulanate, and found that the latter has a more reliable pharmacokinetic profile and is less expensive 5.