Editing Neomycin (section)

==Medical uses==
Neomycin is typically applied as a [[topical]] preparation, such as Neosporin ([[neomycin/polymyxin B/bacitracin]]). The antibiotic can also be administered orally, in which case it is usually combined with other antibiotics. Neomycin is not absorbed from the gastrointestinal tract and has been used as a preventive measure for [[hepatic encephalopathy]] and [[hypercholesterolemia]]. By killing bacteria in the intestinal tract, Neomycin keeps ammonia levels low and prevents hepatic encephalopathy. Due to its poor GI tract absorption, orally administered neomycin has also been used to reduce the risk of post operative infection following [[Gastrointestinal tract|gastrointestinal]] [[Digestive system surgery|surgery]].<ref>{{cite journal | pmc=3686946 | date=2002 | last1=Lewis | first1=R. T. | title=Oral versus systemic antibiotic prophylaxis in elective colon surgery: A randomized study and meta-analysis send a message from the 1990s | journal=Canadian Journal of Surgery. Journal Canadien de Chirurgie | volume=45 | issue=3 | pages=173–180 | pmid=12067168 }}</ref>

Waksman and Lechevalier originally noted that neomycin was active against streptomycin-resistant bacteria as well as ''[[Mycobacterium tuberculosis]]'', the causative agent for [[tuberculosis]].<ref name="Waksman_1949b" /> Neomycin has also been used to treat [[small intestinal bacterial overgrowth]]. Neomycin is not administered via injection, as it is extremely [[nephrotoxic]] (damaging to kidney function) even when compared to other [[aminoglycoside]]s. The exception is when neomycin is included, in small quantities, as a preservative in some vaccines – typically 25&nbsp;μg per dose.<ref>{{cite journal | vauthors = Heidary N, Cohen DE | title = Hypersensitivity reactions to vaccine components | journal = Dermatitis | volume = 16 | issue = 3 | pages = 115–20 | date = September 2005 | pmid = 16242081 | doi = 10.1097/01206501-200509000-00004 | s2cid = 31248441 }}</ref>

In 2022, the combination of neomycin with [[dexamethasone]] and [[polymyxin B]] was the 274th most commonly prescribed medication in the United States, with more than 800,000 prescriptions.<ref>{{cite web | title=The Top 300 of 2022 | url=https://clincalc.com/DrugStats/Top300Drugs.aspx | website=ClinCalc | access-date=30 August 2024 | archive-date=30 August 2024 | archive-url=https://web.archive.org/web/20240830202410/https://clincalc.com/DrugStats/Top300Drugs.aspx | url-status=live }}</ref><ref>{{cite web | title = Dexamethasone; Neomycin; Polymyxin B Drug Usage Statistics, United States, 2013 - 2022 | website = ClinCalc | url = https://clincalc.com/DrugStats/Drugs/DexamethasoneNeomycinPolymyxinB | access-date = 30 August 2024 }}</ref>

===Spectrum===
Similar to other aminoglycosides, neomycin has excellent activity against [[Gram-negative bacteria]] and is partially effective against [[Gram-positive bacteria]]. It is relatively toxic to humans, with allergic reactions noted as a common adverse reaction (see: [[hypersensitivity]]).<ref>{{DermNet|dermatitis/neomycin-allergy}}</ref> Physicians sometimes recommend using antibiotic ointments without neomycin, such as [[Polysporin]].<ref>{{cite web |url=http://www.dermadoctor.com/article_Your-Medicine-Cabinet_43.html |title=Your Medicine Cabinet |publisher=DERMAdoctor.com, Inc. |access-date=2008-10-19 |url-status=dead |archive-url=https://web.archive.org/web/20090709093022/http://www.dermadoctor.com/article_Your-Medicine-Cabinet_43.html |archive-date=2009-07-09}}</ref> The following represents [[minimum inhibitory concentration]] (MIC) susceptibility data for a few medically significant Gram-negative bacteria.<ref>{{cite web |url=http://www.toku-e.com/Assets/MIC/Neomycin%20sulfate%20EP.pdf |title=Neomycin sulfate, EP Susceptibility and Minimum Inhibitory Concentration (MIC) Data |publisher=TOKU-E |access-date=2014-03-31 |archive-date=2015-12-22 |archive-url=https://web.archive.org/web/20151222095539/http://www.toku-e.com/Assets/MIC/Neomycin%20sulfate%20EP.pdf |url-status=live }}</ref>
* ''Enterobacter cloacae'': >16 μg/ml
* ''Escherichia coli'': 1 μg/ml
* ''Proteus vulgaris'': 0.25 μg/ml