Treatment, local antibacterial of conjunctivitis, severe, keratitis and ulcers, cornea due to germs sensitive to neomycin and polymyxin B.

Official recommendations concerning the appropriate use of antibacterials should be taken into account.
1 drop in the lower conjunctival cul-de-sac, 3 to 8 times per day, according to severity for 7 days on average.
Class: Pharmacotherapeutic: ANTIBIOTICS, ANTIBACTERIAL (J: Anti-infectives).
(S: Body of the senses)

Polymyxin B is an antibiotic of the family of polypeptides.
Neomycin is an antibiotic of the family of aminoglycosides

SPECTRUM OF ACTIVITY, ANTI-BACTERIAL

POLYMYXINE B

Critical concentrations separate sensitive strains from strains of intermediate sensitivity and the latter from resistant strains

S mg / l and R> 2; mg / l
The prevalence of acquired resistance may vary according to geography and time for some species. It is therefore useful to have information on the prevalence of local resistance, especially for the treatment of severe infections. These data can only provide guidance on the probabilities of the susceptibility of a bacterial strain to this antibiotic.

When the variability of the resistance prevalence in France is known for a bacterial species, it is indicated in the table below

Categories

Frequency of resistance, acquired in France (> 10%) (extreme values)

SENSITIVE SPECIES

Gram-negative Aerobes

Acinetobacter

Aeromonas

Alcaligenes

Citrobacter freundii

Citrobacter koseri

Enterobacter

Escherichia coli

Klebsiella

Moraxella

Pseudomonas aeruginosa

Salmonella

Shigella

Stenotrophomonas maltophilia

0 - 30%

RESISTANT SPECIES

Gram-positive aerobes

Cocci and bacillus

Gram-negative Aerobes

Branhamella catarrhalis

Brucella

Burkholderia cepacia

Burkholderia pseudomallei

Campylobacter

Chryseobacterium meningosepticum

Legionella

Morganella

Neisseria

Proteus

Providencia

Serratia

Vibrio; cholerae El Tor

Anaerobes

Cocci and bacillus

Other

Mycobacteria

NEOMYCINE

The prevalence of acquired resistance may vary according to geography and time for some species. It is therefore useful to have information on the prevalence of local resistance, especially for the treatment of severe infections. These data can only give an orientation on the probabilities of the susceptibility of a bacterial strain to this antibiotic.
When the variability of the resistance prevalence in France is known for a bacterial species, it is indicated in the table below

Categories

Frequency of resistance, acquired in France (> 10%) (extreme values)

SENSITIVE SPECIES

Gram-positive aerobes

Corynebacterium

Listeria monocytogenes

Staphylococcus meti - S

Gram-negative Aerobes

Acinetobacter (mainly Acinetobacter; baumannii)

50 - 75%

Branhamella catarrhalis

Campylobacter

Citrobacter freundii

20 - 25%

Citrobacter koseri

Enterobacter aerogenes



Enterobacter cloacae

10 - 20%

Escherichia coli

15 - 25%

Haemophilus influenzae

25 - 35%

Klebsiella

10 - 15%

Morganella morganii

10 - 20%

Proteus, mirabilis

20 - 50%

Proteus, vulgaris



Providencia rettgeri



Salmonella



Serratia



Shigella



Yersinia



Categories

Frequency of resistance, acquired in France (> 10%) (extreme values)

MODERATELY SENSITIVE SPECIES

(In vitro of sensitivity, intermediate)

Gram-negative Aerobes

Pasteurella

RESISTANT SPECIES

Gram-positive aerobes

Enterococci

Nocardia, asteroids

Staphylococcus meti-R; *

Streptococcus

Gram-negative Aerobes

Alcaligenes denitrificans

Burkholderia

Flavobacterium sp.

Providencia stuartii

Pseudomonas aeruginosa

Stenotrophomonas maltophilia

Anaerobes

Anaerobic bacteria, strict

Other

Chlamydia

Mycoplasma

Rickettsies

* The frequency of resistance to methicillin is approximately 30 to 50% of all staphylococci and is found mainly in hospital.
Note: These spectra correspond to those of the systemic forms of these antibiotics. With local pharmaceutical presentations, the concentrations obtained in situ are much higher than the plasma concentrations. There is still some uncertainty as to the kinetics of in situ concentrations, the local physico-chemical conditions which may modify the activity of the antibiotic and the stability of the product in situ.

The vision may be scrambled immediately after the instillation.

Hypersensitivity to any of the constituents

- In cases of hypersensitivity, discontinuation of treatment

- In the case of infection of the eye, wearing of lenses is formally contraindicated during the treatment period.
- In the absence of improvement, rapid or prolonged treatment, regular medical surveillance, including bacteriological controls with study of the susceptibility of the germ, makes it possible to detect resistance to the product and, Treatment.

- Eye drops shall not be used in peri-or intra-ocular injection.

- In the case of concomitant treatment with an eye drops containing a different active ingredient, the eye drops should be instilled 15 minutes apart.
- Due to the presence of benzalkonium chloride, this drug may cause eye irritation. Avoid contact with soft contact lenses. Remove contact lenses before application and wait at least 15 minutes before handing in.
The benzalkonium chloride may discolor the soft contact lenses.

The data available to date do not imply the existence of clinically significant interactions.

Without object.

No case of overdose has been reported. However, instillations, which have been repeated for a long time, may lead to a systemic passage of the active ingredients which is not negligible, in addition to an exacerbation of local undesirable effects. >
In the case of ocular administration, systemic passage is not negligible.

The presence of neomycin conditions the conduct, to be taken in case of pregnancy and breast-feeding

Pregnancy

Studies in animals have demonstrated cochleovestibular involvement after parenteral administration of neomycin. Clinically, some cases of fetal cochleovestibular disease have been described with other aminoglycosides after parenteral administration. Accordingly, the use of Atebemyxin, eye drops in solution, should be avoided by caution during pregnancy.


Atebemyxine, eye drops solution may be prescribed during breastfeeding.

Possibility of irritation, transient

Risk of reaction, hypersensitivity

Treatment: local antibacterial of conjunctivitis, severe, keratitis and ulcers, corneals due to neomycin- and polymyxin-sensitive germs B. Official recommendations regarding the appropriate use of antibacterials should be taken into account.