Eradication of Facultative Gut Flora

A combination of neomycin and nonabsorbable eryth-romycin base given orally prior to colorectal surgery can markedly reduce the incidence of postoperative wound infection. Orally administered neomycin is sometimes used to suppress the facultative flora of the gut in patients with hepatic encephalopathy. It is unclear how this improves coma, but one theory is that it reduces systemic absorption of the bacterial metabolites that allegedly cause hepatic encephalopathy. Although more than 95% of an oral dose of neomycin is excreted unchanged in the stool of normal subjects, the bioavailability of neomycin may be much higher in patients with an abnormal gastrointestinal mucosa.

Neomycin is often combined with other antibiotics, such as polymyxin B and bacitracin, and applied as an ointment to prevent any infection of minor skin abrasions, burns, and cuts.

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