Topical nasal antiseptic/antibiotic Pregnancy: Chlorhexidine and neomycin cannot be detected in the blood following application of Naseptin and its use is unlikely to have any effect on the foetus or on breast feeding.

Chlorhexidine with neomycin

Brand names: Naseptin

A combined topical antiseptic-antibacterial preparation of chlorhexidine with the aminoglycoside neomycin, used for the prevention and treatment of superficial skin and nasal bacterial colonisation.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: A small amount is placed on the little finger and applied to the inside of each nostril

Route: Nasal application only (topical intranasal cream)

Frequency: For eradication of infection: four times daily for 10 days. For prophylaxis: twice daily.

Fetched UK SPC is Naseptin Nasal Cream (eMC product 5524) — the chlorhexidine with neomycin combination named on this page, covering both components. §4.2 verbatim: for prophylaxis, applied twice daily 'to prevent patients from becoming carriers and to inhibit the dispersion of Staphylococci'; for eradication of infection, applied four times daily for 10 days 'to eliminate organisms from the nares'. No duration is stated for the prophylactic regimen and no maximum dose is given. Children and elderly patients: §4.2 states 'There are no special dosage recommendations for either children or elderly patients' — no per-kg or age-banded paediatric dose is given, so verify any under-18 use against a children's formulary. §4.4: for nasal application only; keep out of the eyes and ears; irritative skin reactions can occasionally occur; prolonged use of neomycin can lead to skin sensitisation, ototoxicity and nephrotoxicity; use with caution in children, elderly patients and patients with impaired hearing. Contains cetostearyl alcohol, which may cause local skin reactions (e.g. contact dermatitis). The openFDA fallback record fetched is a chlorhexidine gluconate 0.75% antiseptic solution (single component, different formulation) and was not used.

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC; US FDA prescribing information (openFDA / DailyMed) — cross-check; US labelling may differ from UK — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

Patients who have previously shown a hypersensitivity reaction to neomycin or chlorhexidine, although such reactions are extremely rare
Hypersensitivity to the active substances or to any of the excipients listed in section 6.1

Side effects

Anaphylaxis — frequency not known
Ototoxicity — frequency not known (use with caution in children, elderly patients and patients with impaired hearing)
Nephrotoxicity — frequency not known
Irritative skin reactions and skin sensitisation — frequency not known
Temporary hyposmia and temporary ageusia — frequency not known
Application site discolouration — frequency not known

Interactions

None known (SPC §4.5)

Clinical monograph

How it works

Chlorhexidine disrupts microbial cell membranes with persistent surface activity, while neomycin binds the bacterial ribosome to inhibit protein synthesis against susceptible organisms including Staphylococcus aureus.

Prescribing in practice

Topical neomycin is a frequent cause of contact allergic sensitisation, and absorption from large or broken areas risks oto- and nephrotoxicity, so use should be limited in area and duration.
Avoid chlorhexidine contact with the eyes, middle ear and meninges.
Do not apply over extensive denuded skin where systemic aminoglycoside absorption could occur.

Monitoring

Review the treated area for irritation or contact allergy and limit application to small intact areas for short courses.

Counselling the patient

Stop and seek advice if the skin becomes more red, itchy or sore, which may indicate an antibiotic allergy.
Apply only as directed and keep away from the eyes and ears.

Evidence & guidelines

Cautions on neomycin sensitisation and systemic aminoglycoside toxicity follow the SPC and standard dermatology references.

Reference: Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways