Aminoglycoside antibiotic (topical/oral)

Neomycin sulfate

Neomycin sulfate is an aminoglycoside antibacterial used topically, in ear and eye preparations, and orally for bowel decontamination as it is poorly absorbed from the gut.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It binds to the bacterial 30S ribosomal subunit, causing misreading of messenger RNA and inhibiting protein synthesis to produce a bactericidal effect against many Gram-negative organisms.

Prescribing in practice

Systemic absorption (for example from broken skin, large surface areas or in renal impairment) can cause irreversible ototoxicity and nephrotoxicity, so prolonged or extensive use should be avoided.
It is too toxic for parenteral use and is reserved for topical or oral local effect.
Topical use can cause contact sensitisation, and cross-sensitivity with other aminoglycosides may occur.

Monitoring

Watch for signs of hearing loss or balance disturbance with prolonged or oral use, particularly in renal impairment or the elderly.

Counselling the patient

Report any hearing changes, ringing in the ears or dizziness.
Do not apply to large raw areas or use for longer than advised.

Evidence & guidelines

The ototoxic and nephrotoxic potential of aminoglycosides is well established and documented in current prescribing references.

Reference: NICE; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways