新黴素
Neomycin
Neomycin sulfate
別名: 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
由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本
經審核的 v13 劑量證據
結構化劑量計算證據Susceptible enteric infections (extra-label)
- q6-12h
NA
必須同時考慮的臨床上下文 (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.
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
概覽
新黴素是一種廣效、殺菌性的氨基醣苷類抗生素，主要對抗革蘭氏陰性需氧菌。
由於其全身性給藥時的腎毒性顯著高於其他氨基醣苷類藥物（如慶大黴素或阿米卡星），在獸醫學中的應用主要限於：
- 局部應用（皮膚、眼睛、耳朵）
- 口服給藥用於腸道感染或手術前的「腸道滅菌」
- 肝性腦病的處置（減少結腸中產生氨的細菌）
臨床要點： 與所有氨基醣苷類藥物一樣，新黴素具有濃度依賴性殺菌活性和顯著的抗生素後效應 (PAE)。然而，它在完整胃腸道的吸收極差（僅約 3%），這使其非常適合在腸道內發揮局部作用，同時將全身毒性降至最低。
作用機制
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.
安全性與警告
禁忌症
- 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)
不良反應
- 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)
注意事項
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.
藥物相互作用
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
監測
- 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)
藥物動力學
半衰期
吸收
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.
分佈
Distributes to tissues similarly to other aminoglycosides. Does not cross the blood-brain barrier well.
代謝
Not significantly metabolized.
排除
Orally administered neomycin is nearly all excreted unchanged in the feces. Parenterally administered drug is eliminated primarily through renal mechanisms.
過量
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.
可用產品
劑型
- 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
獸醫用
- 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)
人用標示
- 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)
各地核准狀態
Subject to responsible antimicrobial use guidelines.
暫無法規資料: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
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.
飼主須知
- 口服使用： 可能引起腹瀉或改變正常腸道菌叢。請仔細遵循獸醫師的指示。
- 毒性警告： 如果以注射方式給予此藥物，會有極高的腎臟損傷（腎毒性）和聽力喪失/平衡問題（耳毒性）風險。
- 請確保您的寵物隨時有充足的乾淨飲水。
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