네오마이신
Neomycin
Neomycin sulfate
다른 이름: Biosol · Neomix · Neo-325 · Neo-fradin · Neo-Sol 50 · Neovet · Canaural · Soframycin · Neopen · Maxitrol · Nivemycin · fradiomycin sulfate · neomycin sulphate · neomycini sulfas · neomycin B · Framycetin sulphate · Neomycin sulfate · Neomycinum
VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료
감사 완료 v13 용량 근거
구조화 용량 계산 근거Susceptible enteric infections (extra-label)
- q6-12h
NA
반드시 함께 고려할 임상 맥락 (3)
- ■ This medicine may be given by mouth with or without food. If your animal vomits or acts sick after receiving the medicine on an empty stomach, give with food or a small treat to see if this helps.
- Neomycin sulfate oral solution should be stored at room temperature (15°C-30°C [59°F-86°F]) in airtight, light-resistant containers.
- Unless otherwise instructed by the manufacturer, oral tablets/boluses should be stored in airtight containers at room temperature.
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
네오마이신은 주로 그람 음성 호기성 세균에 효과적인 광범위 살균성 아미노글리코사이드계 항생제입니다.
전신 투여 시 다른 아미노글리코사이드계(예: 겐타마이신 또는 아미카신)보다 신독성이 현저히 높기 때문에 수의학에서의 사용은 주로 다음과 같이 제한됩니다:
- 국소 적용 (피부, 눈, 귀)
- 장염 또는 수술 전 "장관 멸균"을 위한 경구 투여
- 간성 뇌증 관리 (결장 내 암모니아 생성 세균 감소)
임상 요점: 모든 아미노글리코사이드계와 마찬가지로 네오마이신은 농도 의존적 살균 활성과 유의미한 항생제 후 효과(PAE)를 나타냅니다. 그러나 온전한 위장관에서는 흡수가 거의 되지 않아(약 3%에 불과), 전신 독성을 최소화하면서 장 내강에서 국소적으로 작용하는 데 이상적입니다.
작용 기전
Neomycin actively transports across the bacterial cell membrane (an oxygen-dependent process, hence its lack of efficacy against anaerobes). It irreversibly binds to the 30S ribosomal subunit → causes misreading of mRNA → inhibits protein synthesis → leads to rapid bacterial cell death.
안전성·주의사항
금기사항
- Intestinal obstruction (for oral use)
- Rabbits and hares (disrupts GI flora)
- Neonates (avoid oral use due to higher systemic absorption)
- Animals with a perforated tympanic membrane (eardrum)
- Concurrent use with other known ototoxic products
- Known hypersensitivity to aminoglycosides
- Pre-existing renal disease (for systemic use)
- Ruptured tympanic membrane (for otic preparations)
부작용
- Nephrotoxicity (severe if given parenterally)
- Ototoxicity (irreversible, parenteral or rarely oral)
- Severe diarrhea
- Intestinal malabsorption
- GI superinfections (with chronic oral use)
- Ototoxicity (deafness)
- Vestibular toxicity (ataxia, head tilt, nystagmus)
- Local irritation or erythema at the application site
- Ototoxicity (vestibular and auditory)
- Severe diarrhoea or malabsorption syndrome (oral use)
- Bacterial or fungal superinfections
- Local irritation (topical ophthalmic use)
주의
Use with extreme caution in patients with renal dysfunction, even when given orally, as a small percentage is absorbed. Avoid parenteral use in working dogs due to the risk of irreversible ototoxicity. Use cautiously in patients with neuromuscular disorders (e.g., myasthenia gravis) due to the neuromuscular blocking activity of aminoglycosides. Geriatric and neonatal animals require careful monitoring and dosage adjustments if systemic absorption is expected.
약물 상호작용
Oral neomycin may decrease digoxin absorption. In a small subset of patients who metabolize digoxin in the GI tract, neomycin may increase serum digoxin levels.
Absorption may be reduced by oral neomycin.
Concurrent use increases the risk of additive toxicity, even with oral neomycin, and should be done with caution.
Concurrent use may cause malabsorption of the penicillin.
Oral neomycin may decrease vitamin K absorption from the gut, potentially increasing anticoagulant effects.
Increased risk of cumulative ototoxicity (deafness and vestibular dysfunction)
Decreased absorption of potassium
Decreased absorption of vitamin K
Synergistic ototoxicity and nephrotoxicity
모니터링
- Clinical efficacy
- Systemic and GI adverse effects with prolonged use
- Renal function parameters (BUN, creatinine, urinalysis) if used parenterally
- Resolution of clinical signs of otitis
- Integrity of the tympanic membrane (via otoscopy)
- Hearing function and vestibular signs (head tilt, ataxia, nystagmus)
- Renal function (BUN, Creatinine, Urinalysis for casts/protein)
- Hearing and vestibular function (head tilt, nystagmus, ataxia)
- Gastrointestinal signs (diarrhoea)
약동학
반감기
흡수
Approximately 3% of a dose is absorbed after oral or rectal administration. Absorption increases if gut motility is slowed or if the bowel wall is damaged. Therapeutic systemic levels are not attained via oral administration.
분포
Distributes to tissues similarly to other aminoglycosides. Does not cross the blood-brain barrier well.
대사
Not significantly metabolized.
배설
Orally administered neomycin is nearly all excreted unchanged in the feces. Parenterally administered drug is eliminated primarily through renal mechanisms.
과다투여
Parenteral overdosage carries a high risk of severe nephrotoxicity and ototoxicity. Oral overdosage is less likely to cause systemic toxicity unless the gut wall is compromised, but can lead to severe diarrhea and malabsorption.
제품
제형
- Oral liquid
- Soluble powder
- Oral tablets
- Topical formulations (ophthalmic, otic, dermatologic)
- Topical: 5 mg/g suspension (often combined with fusidic acid, nystatin, and prednisolone as Canaural)
- Oral: 500 mg tablets
- Parenteral: 100 mg/ml neomycin combined with 200 mg/ml penicillin G
- Topical: 0.25-0.5% dermatological, ophthalmic, and otic preparations
동물용의약품
- Neomycin Sulfate Oral Liquid: 200 mg/mL
- Neomycin Sulfate Soluble Powder: 325 grams/lb (Neo-325, Neovet 325/100, Neo-Sol 50)
- Canaural Ear Drops (Framycetin 5 mg/g, Fusidic acid 5 mg/g, Nystatin 100,000 IU/g, Prednisolone 2.5 mg/g)
- Neopen (100 mg/ml neomycin + 200 mg/ml penicillin G injection)
인용의약품
- Neomycin Sulfate Tablets: 500 mg
- Neomycin Sulfate Oral Solution: 25 mg/mL (Neo-fradin)
- Soframycin (Framycetin sulfate 1% topical/ophthalmic preparations - availability varies by region)
- Nivemycin (500 mg tablets)
- Maxitrol (ophthalmic drops/ointment)
규제 현황
Subject to responsible antimicrobial use guidelines.
규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
Store oral solutions and tablets at room temperature (15-30°C) in tight, light-resistant containers. In the dry state, neomycin is stable for at least 2 years at room temperature.
보호자 정보
- 경구 사용: 설사를 유발하거나 정상적인 장내 세균총을 변화시킬 수 있습니다. 수의사의 지시를 주의 깊게 따르십시오.
- 독성 경고: 이 약물을 주사로 투여할 경우 신장 손상(신독성) 및 청력 상실/평형 문제(이독성)의 위험이 매우 높습니다.
- 반려동물이 항상 신선한 물을 마실 수 있도록 해주세요.
VetSheet 의약품 참고자료는 수의사 전문가의 임상 의사결정 지원을 위한 것이며, 전문적 판단이나 제조사의 최신 약물 정보를 대체할 수 없습니다.