Comparative Pharmacology
Head-to-head clinical analysis: KANAMYCIN SULFATE versus NEOMYCIN AND POLYMYXIN B SULFATES AND GRAMICIDIN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: KANAMYCIN SULFATE versus NEOMYCIN AND POLYMYXIN B SULFATES AND GRAMICIDIN.
KANAMYCIN SULFATE vs NEOMYCIN AND POLYMYXIN B SULFATES AND GRAMICIDIN
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Aminoglycoside antibiotic that irreversibly binds to the 30S ribosomal subunit, inhibiting protein synthesis and causing mRNA misreading.
Neomycin and gramicidin are aminoglycoside and polypeptide antibiotics, respectively, that inhibit bacterial protein synthesis by binding to the 30S and 50S ribosomal subunits, while polymyxin B is a cationic detergent that disrupts bacterial cell membrane integrity by binding to lipopolysaccharides.
15 mg/kg/day IM or IV divided every 8-12 hours; typical adult dose: 500 mg IM every 12 hours or 7.5 mg/kg every 12 hours. Maximum total daily dose: 1.5 g.
1-2 drops or a small amount applied to affected eye(s) every 4 hours, or more frequently if severe, for up to 7-10 days. Ophthalmic ointment: apply a 1/2-inch ribbon into conjunctival sac every 3-4 hours.
None Documented
None Documented
Terminal elimination half-life is 2-4 hours in adults with normal renal function; prolonged to 30-60 hours in severe renal impairment (CrCl <10 mL/min).
Neomycin: plasma half-life ~2-3 hours in patients with normal renal function, but can extend to 12-24 hours or more in renal impairment. Polymyxin B: half-life ~6 hours in normal renal function, prolonged significantly in renal failure (up to 2-3 days). Gramicidin: not systemically absorbed; half-life not applicable.
Renal excretion of unchanged drug accounts for 80-90% of elimination; minor biliary excretion (<1%) and fecal elimination (<1%).
Neomycin and polymyxin B sulfates and gramicidin are poorly absorbed from intact skin or ophthalmic sites. After topical application, absorbed neomycin is excreted primarily unchanged in urine (30-50% of absorbed dose) via glomerular filtration; polymyxin B is excreted slowly via renal tubular secretion and glomerular filtration (60-70% of absorbed dose in urine); fecal elimination accounts for minor amounts. Gramicidin is not significantly absorbed.
Category C
Category A/B
Aminoglycoside Antibiotic
Aminoglycoside Antibiotic