Polymyxin B and Gramicidin
Place in Therapy
Place in Therapy
In practice, patients may be more comfortable using ophthalmic solutions. According to Patient Self Care and the Practical Guide to Non-prescription Drugs, polymyxin B/gramicidin are comparable to polymxin B/bacitracin and either can be recommended.(1,2) The studies by Gibson and Nozik et al state that polymyxin B/gramicidin is considered safe and efficacious.(1-4) However no primary literature could be found comparing the ophthalmic solution to the ointment, polymyxin B and gramicidin to placebo or the ophthalmic solution without neomycin in the formulation. Given the lack of evidence, we would recommend polymyxin B and gramicidin only to patients who do not wish to use or who cannot use the polymyxin B and bacitracin ointment.
References
In practice, patients may be more comfortable using ophthalmic solutions. According to Patient Self Care and the Practical Guide to Non-prescription Drugs, polymyxin B/gramicidin are comparable to polymxin B/bacitracin and either can be recommended.(1,2) The studies by Gibson and Nozik et al state that polymyxin B/gramicidin is considered safe and efficacious.(1-4) However no primary literature could be found comparing the ophthalmic solution to the ointment, polymyxin B and gramicidin to placebo or the ophthalmic solution without neomycin in the formulation. Given the lack of evidence, we would recommend polymyxin B and gramicidin only to patients who do not wish to use or who cannot use the polymyxin B and bacitracin ointment.
References
- Friesen AM. Chapter 15: Eye Care – Conjunctivitis. Patient Self Care 2nd ed. Canadian Pharmacist Association. 2010; 121-126.
- Ang A, Bouchard P, Champagne MC, Hildebrand M, Kim JH, Lampron AM et al. The Practical Guide to Non-prescription Drugs, 2nd Edition. Pharmascience Inc, Quebec. 2008: 169-170, 172, 174.
- Gibson JR. Trimethoprim-polymyxin B ophthalmic solution in the treatment of presumptive bacterial conjunctivitis – A multicentre trial of its efficacy versus neomycin-polymyxin B-gramicidin and chloramphenicol ophthalmic solutions. J Antimicro Chemo 1983;11:217-21.
- Nozik RA, Smolin G, Knowlton G, Austin R. Trimethoprim – Polymyxin B Ophthalmic Solution in Treatment of Surface Ocular Bacterial Infections. Ann Ophthamol, 1985;17(12):746-8.