Comparative Pharmacology
Head-to-head clinical analysis: BETHKIS versus NEOMYCIN POLYMYXIN B SULFATES BACITRACIN ZINC HYDROCORTISONE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: BETHKIS versus NEOMYCIN POLYMYXIN B SULFATES BACITRACIN ZINC HYDROCORTISONE.
BETHKIS vs NEOMYCIN & POLYMYXIN B SULFATES & BACITRACIN ZINC & HYDROCORTISONE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Tobramycin, an aminoglycoside antibiotic, binds to the 30S ribosomal subunit, causing misreading of mRNA and inhibiting protein synthesis, leading to bacterial cell death.
Neomycin, polymyxin B, and bacitracin are antibiotics that inhibit bacterial protein synthesis, disrupt cell membrane integrity, and interfere with cell wall synthesis, respectively. Hydrocortisone is a corticosteroid that suppresses inflammation by inhibiting phospholipase A2, reducing prostaglandin and leukotriene synthesis.
4 IU/kg (1 mg/kg) intramuscularly or subcutaneously once weekly for 4 weeks, then a maintenance dose of 2 IU/kg (0.5 mg/kg) once weekly.
Apply to affected area 3-4 times daily. Not for use in eyes.
None Documented
None Documented
Terminal elimination half-life 2-3 hours in patients with normal renal function; prolonged to 20-40 hours in severe renal impairment (CrCl <30 mL/min).
Neomycin: 2-3h (normal renal); polymyxin B: 4-6h (normal renal), prolonged to 2-3 days in renal impairment; bacitracin: ~1.5h after IM; hydrocortisone: 1.5-2h (plasma). Topical: systemic levels negligible.
Primarily renal excretion of unchanged drug via glomerular filtration; ~90% of absorbed dose excreted in urine within 24 hours; biliary/fecal elimination <5%.
Neomycin: >90% renal (unchanged) after parenteral; polymyxin B: ~60% renal (unchanged) over 72h; bacitracin: >90% renal (unchanged) after IM; hydrocortisone: hepatic metabolism, metabolites renally eliminated (<1% unchanged). Topical: negligible systemic absorption across intact skin (except bacitracin may be minimally absorbed).
Category C
Category A/B
Aminoglycoside Antibiotic
Aminoglycoside Antibiotic