Practical information on using framycetin and neomycin

This topic covers practical information on using the aminoglycosides framycetin and neomycin. For information on the aminoglycosides gentamicin, tobramycin and amikacin, see Principles of aminoglycoside use. For information on the aminoglycoside paromomycin, see Practical information on using paromomycin.

Framycetin and neomycin are rapidly bactericidal and are used to treat infections caused by aerobic gram-negative bacteria.

Framycetin is used topically for superficial ear infections (in combination with other drugs) and eye infections. Framycetin eye drops can cause contact hypersensitivity reactions, which can be severe.

Neomycin is used topically for superficial ear infections (in combination with other drugs). It may be used, in combination with other interventions, as an oral nonabsorbable antibiotic for surgical prophylaxis for elective colorectal resections.

If possible, avoid ear drops containing framycetin or neomycin in patients with a perforated tympanic membrane or a tympanostomy tube in situ because of the risk of inner ear damage; however, this complication appears to be rare. It is also preferable to avoid aminoglycosides if the tympanic membrane cannot be visualised, in case it is perforated.