Oxytetracycline + Polymixin B Sulphate

Ophthalmic Infections:

• Bacterial conjunctivitis
• Blepharitis and blepharoconjunctivitis
• Trachoma (as adjunct therapy)
• Superficial ocular infections caused by susceptible organisms
• Prophylaxis of post-traumatic or post-surgical ocular infections

Dermatological Infections (Topical):

• Minor skin infections (cuts, abrasions, burns)
• Impetigo
• Infected eczema
• Secondary bacterial infections in pre-existing dermatoses

Ophthalmic Ointment:

• Apply 1 cm ribbon into the lower conjunctival sac every 2–4 hours initially
• Reduce frequency as improvement occurs
• Typical duration: 5 to 7 days

Topical Skin Ointment:

• Apply a thin layer to the affected skin area 2 to 3 times daily
• Clean the area before each application

Pediatrics:

• Safe for children >2 months with short-term use under supervision

Elderly:

• No specific dose adjustment required

Renal/Hepatic Impairment:

• Not systemically absorbed to a significant degree; no dosage adjustment necessary

Oxytetracycline is a bacteriostatic tetracycline antibiotic that inhibits bacterial protein synthesis by binding to the 30S ribosomal subunit, thereby blocking aminoacyl-tRNA binding.
Polymyxin B Sulphate is a bactericidal cyclic polypeptide that binds to lipopolysaccharides on the outer membrane of gram-negative bacteria, disrupting membrane integrity and leading to cell death.
The combination provides broad-spectrum coverage against both gram-positive and gram-negative organisms, especially in ocular and superficial skin infections.

• Absorption: Minimal systemic absorption through the conjunctiva or intact skin
• Distribution: Primarily localized to the application site
• Metabolism: Not metabolized significantly due to low systemic exposure
• Excretion: Minimal renal or biliary elimination
• Half-life: Not clinically relevant for topical/ocular use
• Onset: Within hours of application

• Pregnancy:
• Oxytetracycline is FDA Category D (systemic use), but short-term ophthalmic or topical use is generally considered low risk.
• Avoid prolonged use in late pregnancy due to potential for fetal teeth discoloration.
• Lactation:
• Systemic absorption is negligible; safe with short-term topical or ophthalmic use.
• Monitor infant for signs of allergic reaction if breastfeeding.

• Topical antibiotic combination
• Ophthalmic antimicrobial agent

• Known hypersensitivity to oxytetracycline, polymyxin B, or other tetracyclines
• Viral or fungal infections of the eye or skin
• Severe ocular trauma requiring systemic antibiotics
• Do not use in deep or puncture wounds without medical supervision

• Allergic reactions (e.g., rash, redness, swelling) may occur
• Photosensitivity (though rare with topical use)
• Prolonged use may lead to fungal overgrowth or antibiotic resistance
• Avoid contact lens use during treatment of eye infections
• Use with caution in neonates and premature infants

Ocular Use:

• Temporary burning, stinging, or blurred vision
• Local irritation, itching
• Hypersensitivity reactions (rare)

Topical Use:

• Local skin irritation or contact dermatitis
• Erythema, dryness
• Superinfection with prolonged use

• No significant systemic drug interactions expected due to minimal absorption
• Do not use concurrently with other topical ophthalmic antibiotics unless prescribed
• No effect on CYP450 enzyme systems

• No recent major changes in global or local guidelines
• Still recommended as a first-line ophthalmic combination for minor bacterial eye infections
• Clinical practice emphasizes short-term use only to minimize resistance risk

• Store below 25°C
• Protect from light and moisture
• Do not freeze
• Discard ophthalmic ointment 28 days after opening
• Keep out of reach of children