Framycetin sulfate

How it works

Like other aminoglycosides it binds the bacterial 30S ribosomal subunit, causing misreading of messenger RNA and inhibition of protein synthesis, giving a bactericidal effect against many Gram-negative and some Gram-positive organisms.

Prescribing in practice

• Avoid use with a perforated eardrum or where there is a risk of middle-ear access, because aminoglycosides applied to the inner ear can cause ototoxicity.
• Prolonged or repeated topical use may cause local sensitisation and encourage overgrowth of resistant organisms or fungi.
• Restrict to short courses for confirmed or strongly suspected susceptible infection in line with the SPC and current prescribing references.

Monitoring

Monitoring is mainly clinical, reviewing the treated site for resolution of infection and for signs of local hypersensitivity, and reassessing if there is no improvement.

Counselling the patient

• Use the preparation only at the site directed and for the short course prescribed.
• Stop and seek advice if you develop increasing redness, itching or swelling at the treated area.
• Do not share the medicine or use leftover product for new symptoms.

Evidence & guidelines

Topical aminoglycosides such as framycetin are long-established for localised susceptible bacterial infection, with use guided by antimicrobial stewardship principles.