Dexamethasone; Neomycin; Polymyxin B

What it is

A fixed combination eye drop or eye ointment holding a corticosteroid and two antibiotics. Each mL of the suspension contains neomycin sulfate equivalent to neomycin 3.5 mg, polymyxin B sulfate 10,000 units and dexamethasone 0.1%. Dexamethasone suppresses inflammation, neomycin is an aminoglycoside that blocks bacterial protein synthesis at the 30S ribosomal subunit, and polymyxin B covers Gram-negative organisms including Pseudomonas aeruginosa. The anti-infective component does not cover Serratia marcescens or streptococci, including Streptococcus pneumoniae. The same drug combination is also widely put into ears, which is not what the ophthalmic label covers.

What the research says

The combination exists for the situation where an eye needs a steroid and there is infection or a risk of infection. The pieces have decent evidence separately and poor evidence together. Topical antibiotics modestly speed resolution of acute bacterial conjunctivitis - 68.2% resolved on antibiotic versus 55.5% on placebo by days 4 to 9, moderate certainty. Antibiotic-steroid drops beat placebo in acute otitis externa, though on a single trial with a very wide confidence interval. But the direct question - does adding a steroid to a topical antibiotic help? - is answered no: in chronic suppurative otitis media the pooled risk ratio was 1.08 (95% CI 0.96 to 1.21), and quinolone antibiotics without a steroid did better than aminoglycoside-plus-steroid drops. The harms are real and specific: neomycin is a recognised contact allergen, sensitising about 2.29% of a large patch-tested population, and prolonged ocular dexamethasone raises intraocular pressure and can cause glaucoma and posterior subcapsular cataract.

Evidence grade: Limited evidence.

How it works

Drug class: Fixed-combination topical corticosteroid (dexamethasone) plus aminoglycoside antibiotic (neomycin) and polypeptide antibiotic (polymyxin B)

Dexamethasone damps down the inflammatory response in the treated tissue, which also means it damps down the local immune defence and probably slows healing - which is exactly why an antibiotic is packaged with it. Neomycin kills bacteria by binding irreversibly to the 30S ribosomal subunit and halting bacterial protein synthesis. Polymyxin B covers Gram-negative organisms the aminoglycoside may miss, including Pseudomonas aeruginosa. (Source 1)

What it is used for

• This is the licensed indication: the steroid is there for the inflammation and the antibiotics for the infection risk. The label is explicit that the combination's advantage is convenience and compliance rather than demonstrated superiority, and we found no randomised trial of this specific triple product against its components. Evidence: limited. (Source 2)
• Listed on the label as conditions in which ocular corticosteroids are indicated. The evidence cited is the general case for ocular steroids rather than trials of this combination. Evidence: limited. (Source 2)
• For the antibiotic part the evidence is good and the benefit is modest: in the 2023 Cochrane review 68.2% of antibiotic-treated participants had resolved by days 4 to 9 versus 55.5% on placebo, a 12.7 percentage point absolute difference, RR 1.26 (95% CI 1.09 to 1.46), moderate certainty. Most trials used fluoroquinolones; non-fluoroquinolone antibiotics were the ones linked to more ocular side effects. Evidence: established. (Source 3)
• Antibiotic-steroid ear drops were significantly better than placebo drops in the Cochrane review, but on one trial with an odds ratio of 11 and a 95% confidence interval from 2.00 to 60.57, and the overall quality of studies was low. In general the choice between topical treatments did not change the outcome, so the review suggests choosing on ototoxicity and contact sensitivity risk instead. Evidence: limited. (Source 4)
• Adding a steroid to a topical antibiotic made no detectable difference to resolution of discharge at one to two weeks: RR 1.08 (95% CI 0.96 to 1.21), very low certainty. Quinolone antibiotics without a steroid did better than aminoglycoside-plus-steroid drops, RR 0.77 (95% CI 0.71 to 0.83), low certainty, and that matters here because neomycin is an aminoglycoside. Evidence: not-supported. (Source 5)

Interactions

• CYP3A4 inhibitors, including ritonavir and azole antifungals (label): Even in an eye drop, enough dexamethasone can be absorbed that a CYP3A4 inhibitor slows its clearance; the label records Cushing's syndrome and adrenal suppression in predisposed patients, including children, on CYP3A4 inhibitors. Grapefruit juice inhibits CYP3A4 and St John's wort induces it, but the label names neither and we found no study of either with ophthalmic dexamethasone, so for those two the concern is theoretical. (Source 6)
• Other topical or systemic aminoglycosides (gentamicin, tobramycin, streptomycin) (label): Someone sensitised to neomycin in these drops may react to other aminoglycosides given on the skin or by injection, so the sensitisation is not confined to this product. (Source 7)
• Creams and emollients containing lanolin, benzocaine, thimerosal or parabens (case reports): Not a pharmacological interaction but a clinically important one: three-quarters of people sensitised to neomycin were also sensitised to other haptens, particularly ingredients of creams and emollients, so a reaction blamed on the drops may be partly or wholly due to something else applied nearby. (Source 8)
• Prolonged use alongside any topical antibacterial (label): Keeping the antibiotic going for a long time lets organisms that it does not cover take over, including fungi, and the steroid makes a fungal corneal infection more likely to be missed. (Source 9)
• Alcohol, foods and supplements (label): We found no documented interaction of this ophthalmic combination with alcohol, foods or specific supplements. Systemic exposure from eye drops is low, and the only food-related pathway with any documented basis is CYP3A4 inhibition affecting dexamethasone, which the label states as a class effect rather than naming grapefruit. (Source 6)

Stopping it

• The drops are meant to be tapered rather than stopped abruptly after heavy use: the label's position is to reduce the frequency as the inflammation subsides and then stop. (Source 6)
• There is a limit on quantity rather than a taper schedule: no more than 20 mL should be dispensed initially and the prescription should not be refilled without re-examining the eye with magnification. (Source 10)
• Treatment should be stopped if hypersensitivity develops during use, and reassessed if there is no improvement after two days. (Source 7)
• Intraocular pressure has to be monitored once use passes 10 days, which is the practical trigger for deciding whether to continue or stop. (Source 11)

What goes wrong

Neomycin sensitised 2.29% of a large patch-tested outpatient population, and most of those sensitised reacted to other allergens too. (Source 8)

• Survey study, Moderate certainty.
• Size: 30,629 outpatients patch tested.
• Who: outpatients in north-eastern Italy patch tested for suspected allergic contact dermatitis, 1997 to 2021.
• How long: 25 years of multi-centre data; patches read at 48 hours.
• Result: 701/30,629 (2.29%) sensitised, falling over time especially after 2003; 74.5% of those sensitised were also positive to other haptens; risk rose with age, highest in women over 60 with leg dermatitis.
• Funding: independent - the authors state they received no specific funding for this work.

Prevalence of neomycin sensitisation was 2.29% (=701/30 629), significantly decreasing over time, especially after 2003.

Neomycin in this product can sensitise the skin, and sensitisation can cross over to other aminoglycosides given topically or systemically. (Source 7)

• Official position, Certainty not rated.
• Size: not stated.
• Who: users of neomycin-containing preparations.
• How long: any.
• Result: No rate given. Reactions range from local effects to erythema, itching, urticaria, rash, anaphylaxis, anaphylactoid reactions or bullous reactions.
• Funding: not applicable - regulator-approved labelling, revised September 2024.

Products containing neomycin sulfate may cause cutaneous sensitization. Sensitivity to topically administered aminoglycosides, such as neomycin, may occur in some patients.

Prolonged use of the corticosteroid component can cause glaucoma with optic nerve damage, loss of visual field and posterior subcapsular cataract. (Source 11)

• Official position, Moderate certainty.
• Size: not stated.
• Who: people using ocular corticosteroids for prolonged periods.
• How long: prolonged use; the label requires intraocular pressure monitoring from 10 days.
• Result: No rate given in the label; it also warns of corneal and scleral thinning with possible perforation, suppressed host immune response and masked infection.
• Funding: not applicable - regulator-approved labelling, revised September 2024.

Prolonged use of corticosteroids may result in glaucoma with damage to the optic nerve, defects in visual acuity and fields of vision, and in posterior subcapsular cataract formation.

No frequency can be given for the harms of this combination because the label itself has no denominator. (Source 12)

• Official position, Very low certainty.
• Size: none - the label states no denominator of treated patients is available.
• Who: users of corticosteroid/anti-infective eye combinations.
• How long: any.
• Result: Allergic sensitisation from the anti-infective; raised intraocular pressure with possible glaucoma, infrequent optic nerve damage, posterior subcapsular cataract and delayed wound healing from the steroid; perforation of the globe reported.
• Funding: not applicable - regulator-approved labelling, revised September 2024.

Exact incidence figures are not available since no denominator of treated patients is available.

Non-fluoroquinolone antibiotic eye drops were linked to more treatment-associated ocular complications than placebo, though on very low certainty evidence. (Source 13)

• Systematic review, Very low certainty.
• Size: 21 randomised trials, 8,805 participants.
• Who: people with acute bacterial conjunctivitis.
• How long: course of therapy.
• Result: Non-fluoroquinolones RR 4.05 (95% CI 1.36 to 12.00) for ocular complications such as eye pain, discomfort and allergic reactions, versus fluoroquinolones RR 0.70 (95% CI 0.54 to 0.90); certainty very low.
• Funding: independent (Cochrane-derived summary)

Non-FQs (RR: 4.05; 95% CI: 1.36-12.00), but not FQs (RR: 0.70; 95% CI: 0.54-0.90), were likely to increase treatment-associated ocular complications such as eye pain, discomfort, and allergic reactions; the certainty of level of evidence was very low.

Minor side effects were reported in 16% of participants in both the antibiotic-steroid and the control group in the one trial that reported them. (Source 14)

• Systematic review, Very low certainty.
• Size: one study of 123 participants within a review of 19 studies.
• Who: people with chronic suppurative otitis media.
• How long: one to more than four weeks.
• Result: Minor side effects in 16% of participants in both groups, so no excess attributable to the drops in that trial.
• Funding: independent (Cochrane review)

One study (123 participants) noted minor side effects in 16% of participants in both groups.

Harms of antibiotic and antibiotic-steroid ear drops are poorly reported, so the ototoxicity question for aminoglycosides such as neomycin remains unanswered by trials. (Source 15)

• Systematic review, Very low certainty.
• Size: 19 studies, at least 2,044 participants.
• Who: adults and children with chronic suppurative otitis media.
• How long: one to two weeks mainly.
• Result: No usable harm estimates. The review states the two antibiotic classes are believed to differ in harm profile but the included studies cannot support any comment.
• Funding: independent (Cochrane review)

These two groups of compounds are believed to have different harmful effect profiles, but there is insufficient evidence from the included studies to make any comment about possible harms. In general, harmful effects were poorly reported.

Neomycin raised the frequency of chromosome aberrations in cultured human lymphocytes, and dexamethasone was teratogenic in mice and rabbits after topical eye application. (Source 16)

• Lab study in cells, Very low certainty.
• Size: cultured human lymphocytes; mouse and rabbit studies.
• Who: laboratory cells and animals, not humans.
• How long: not stated.
• Result: Chromosome aberrations increased at the highest neomycin concentration tested, 80 mcg/mL; the label states the human relevance is unknown. Dexamethasone produced fetal resorptions and cleft palate in mice and multiple abnormalities in rabbits at multiples of the therapeutic dose.
• Funding: not applicable - regulator-approved labelling, revised September 2024.

Treatment of cultured human lymphocytes in vitro with neomycin increased the frequency of chromosome aberrations at the highest concentration (80 mcg/mL) tested.

What the evidence supports

Topical antimicrobials containing a steroid cleared acute otitis externa better than placebo drops. (Source 4)

• Systematic review, Very low certainty.
• Size: 19 randomised trials, 3,382 participants in the review; the placebo comparison rests on one trial.
• Who: people with uncomplicated acute otitis externa.
• How long: treatment courses of about 7 to 10 days with follow-up to 3 weeks.
• Result: OR 11 (95% CI 2.00 to 60.57) from a single trial. The review states the overall quality of studies was low.
• Funding: independent (Cochrane review)

Topical antimicrobials containing steroids were significantly more effective than placebo drops: OR 11 (95% CI 2.00 to 60.57; one trial).

Topical antibiotics modestly speed clinical resolution of acute bacterial conjunctivitis, and the absolute difference is about 13 percentage points. (Source 3)

• Systematic review, Moderate certainty.
• Size: 21 randomised trials, 8,805 participants randomised; 1,474 in the clinical cure analysis.
• Who: people with acute bacterial conjunctivitis in primary care.
• How long: outcomes assessed at days 4 to 9 and at end of therapy.
• Result: RR 1.26 (95% CI 1.09 to 1.46), moderate certainty; 55.5% (408/735) resolved on placebo versus 68.2% (504/739) on antibiotic by days 4 to 9.
• Funding: independent (Cochrane review)

In the placebo group, 55.5% (408/735) of participants had spontaneous clinical resolution by days 4 to 9 versus 68.2% (504/739) of participants treated with an antibiotic.

The regulator's position is that the eye drops are approved for steroid-responsive inflammatory eye conditions where bacterial infection, or a risk of it, exists; this is a licensing decision, not trial evidence for this specific combination. (Source 2)

• Official position, Certainty not rated.
• Size: not applicable.
• Who: people with steroid-responsive inflammatory eye conditions.
• How long: not stated.
• Result: No effect size - an approved indication.
• Funding: not applicable - regulator-approved labelling, revised September 2024.

For steroid-responsive inflammatory ocular conditions for which a corticosteroid is indicated and where bacterial infection or a risk of bacterial infection exists.

What the evidence does not support

Adding a topical steroid to a topical antibiotic did not improve resolution of ear discharge in chronic suppurative otitis media. (Source 5)

• Systematic review, Very low certainty.
• Size: 4 studies, 475 participants for the comparison; 3 studies, 335 participants pooled.
• Who: adults and children with chronic ear discharge through a perforated tympanic membrane.
• How long: one to two weeks; no data beyond four weeks.
• Result: RR 1.08 (95% CI 0.96 to 1.21), very low certainty evidence.
• Funding: independent (Cochrane review)

There may be little to no difference in resolution of discharge between topical antibiotic-steroid combinations compared to topical antibiotics alone at one to two weeks, but the evidence is very uncertain (risk ratio (RR) 1.08, 95% confidence interval (CI) 0.96 to 1.21; 3 studies, 335 participants; very low certainty evidence).

The Cochrane reviewers found no evidence that adding a steroid to a topical antibiotic affects resolution of ear discharge, and reported publication bias in this literature. (Source 15)

• Systematic review, Very low certainty.
• Size: 19 studies, at least 2,044 participants, across 13 treatment comparisons.
• Who: adults and children with chronic suppurative otitis media.
• How long: one to two weeks mainly; long-term outcomes absent.
• Result: No effect detected; the review names high risk of bias, imprecision and publication bias as the reasons for low to very low certainty.
• Funding: independent (Cochrane review)

We found no evidence that the addition of steroids to topical antibiotics affects the resolution of ear discharge at one to two weeks, and no data were available for longer-term outcomes.

Quinolone antibiotic drops without a steroid cleared ear discharge more often than aminoglycoside-plus-steroid drops. (Source 5)

• Systematic review, Low certainty.
• Size: 6 studies, 814 participants.
• Who: adults and children with chronic suppurative otitis media.
• How long: one to two weeks; results beyond four weeks uncertain.
• Result: RR 0.77 (95% CI 0.71 to 0.83), I2 = 44%, low-certainty evidence, favouring quinolone alone over non-quinolone (aminoglycoside) with steroid.
• Funding: independent (Cochrane review)

Resolution of discharge may be more likely with quinolone topical antibiotics alone at one to two weeks compared with non-quinolone topical antibiotics (aminoglycosides) with steroids (RR 0.77, 95% CI 0.71 to 0.83; I2 = 44%; 6 studies, 814 participants; low-certainty evidence)

In acute otitis externa, which topical treatment is chosen generally does not change the cure rate. (Source 4)

• Systematic review, Low certainty.
• Size: 19 randomised trials, 3,382 participants.
• Who: people with uncomplicated acute otitis externa.
• How long: follow-up to 2 to 3 weeks.
• Result: No clinically meaningful differences in clinical cure rates between topical interventions, with the exception of acetic acid, which was less effective than antibiotic/steroid drops at weeks 2 and 3.
• Funding: independent (Cochrane review)

In general, no clinically meaningful differences were noted in clinical cure rates between the various topical interventions reviewed.

It is still not possible to say whether aminoglycoside drops such as neomycin are better or worse than quinolones for chronic ear discharge. (Source 17)

• Systematic review, Very low certainty.
• Size: 7 studies, 794 participants.
• Who: adults and children with chronic suppurative otitis media.
• How long: one to two weeks.
• Result: RR 1.92 (95% CI 1.00 to 3.67) favouring quinolones, very low certainty, with considerable heterogeneity (I2 = 97%)
• Funding: independent (Cochrane review)

Resolution of discharge at one to up to two weeks may be higher in the quinolones group, but the evidence is very uncertain (RR 1.92, 95% CI 1.00 to 3.67; 7 studies, 794 participants; very low-certainty evidence).

A 2025 Cochrane review could not say how well topical antibiotics clear chronic ear discharge, because the evidence was limited and of low or very low certainty. (Source 18)

• Systematic review, Very low certainty.
• Size: Cochrane review of randomised trials in chronic suppurative otitis media.
• Who: people with chronic suppurative otitis media (CSOM)
• How long: short-term.
• Result: No pooled estimate in the conclusion.
• Funding: independent - Cochrane review.

Limit of this finding: This is about topical antibiotics as a class in chronic ear discharge, not about this eye product; use in the ear is off-label for it.

We are very uncertain about the effectiveness of topical antibiotics in improving resolution of ear discharge in people with CSOM because of the limited amount of low- or very low-certainty evidence available.

Where the research disagrees

Whether putting a steroid in with the antibiotic adds anything

• Cochrane review of topical antibiotics with steroids for chronic suppurative otitis media, 2025, systematic review with GRADE, 19 randomised trials: We found no evidence that the addition of steroids to topical antibiotics affects the resolution of ear discharge at one to two weeks, and no data were available for longer-term outcomes. (Source 15)
• The approved product labelling, revised September 2024, regulatory position; the stated advantage is convenience and compliance, not a demonstrated outcome benefit: When a decision to administer both a corticosteroid and an antimicrobial is made, the administration of such drugs in combination has the advantage of greater patient compliance and convenience, with the added assurance that the appropriate dosage of both drugs is administered (Source 1)

How much

• Reference intake: There is no reference intake for a topical eye medicine; dosing is set by the prescriber. The label states as a position (revised September 2024) that one to two drops go in the conjunctival sac, hourly in severe disease and tapering as inflammation subsides, or four to six times daily in mild disease. (Source 6)
• Upper limit: No upper limit is defined. The label's position (revised September 2024) is a quantity cap rather than a dose cap: not more than 20 mL initially, with no refill without re-examination; and intraocular pressure monitoring once use reaches 10 days. The strength is fixed at neomycin 3.5 mg, polymyxin B sulfate 10,000 units and dexamethasone 0.1% per mL. (Source 19)
• Studied: The chronic suppurative otitis media trials pooled by Cochrane gave any combination of topical antibiotic plus topical corticosteroid applied directly into the ear canal, with at least one week of follow-up. (Source 15)
• Studied: The acute otitis externa trials pooled by Cochrane used topical antibiotic/steroid drops, acetic acid, or steroid-only drops, usually for seven to ten days, with ear cleaning as part of treatment in 11 of 19 trials. (Source 4)
• Studied: The conjunctivitis trials pooled by Cochrane used topical antibiotic drops or ointment, mostly fluoroquinolones, with three trials of macrolides alone or combined with steroids. (Source 13)

A common belief, and what the research shows

The belief: The steroid in antibiotic-steroid drops makes them work better than the antibiotic alone.

What the research shows: Where it has been tested head to head, it does not. In chronic suppurative otitis media the Cochrane reviewers reported that “We found no evidence that the addition of steroids to topical antibiotics affects the resolution of ear discharge at one to two weeks, and no data were available for longer-term outcomes.” Quinolone drops without a steroid actually did better than aminoglycoside-with-steroid drops, RR 0.77 (95% CI 0.71 to 0.83). The label's own stated case for the combination is “greater patient compliance and convenience”, not better results. A second misconception is that the steroid is harmless locally: prolonged ocular corticosteroid use can cause glaucoma and posterior subcapsular cataract, which is why the label requires intraocular pressure monitoring from 10 days of use.

Questions and answers

What is it?

A combination eye drop or ointment holding one steroid and two antibiotics. Each mL of the suspension has neomycin 3.5 mg, polymyxin B sulfate 10,000 units and dexamethasone 0.1%. The same combination is often used in ears, which the eye label does not cover. (Source 19)

What does it do in the body?

Dexamethasone suppresses inflammation in the treated tissue, which also suppresses the local immune defence and probably slows healing - the reason an antibiotic is included. Neomycin stops bacteria making protein by binding irreversibly to the 30S ribosomal subunit, and polymyxin B covers Gram-negative organisms including Pseudomonas aeruginosa. The product does not cover Serratia marcescens or streptococci including Streptococcus pneumoniae. (Source 20)

Is it good or bad for you?

Good in the specific situation it is licensed for - an inflamed eye that needs a steroid where bacterial infection is present or likely - and for a short course. Bad as a long-running treatment or as a default: prolonged ocular steroid can cause glaucoma and posterior subcapsular cataract and can mask or worsen infection, neomycin sensitises about 2.29% of patch-tested patients, and where the steroid-plus-antibiotic question has been tested directly the steroid added nothing. (Source 11)

How do you get more of it?

It is a prescription product and there is no reason in the literature to want more of it; the label caps the initial quantity at 20 mL and bars refills without re-examining the eye. The trials that tested antibiotic-steroid drops gave them for about a week to ten days, and the reviews found extending or intensifying treatment did not improve outcomes. (Source 7)

If it is harmful, what reduces it?

Stop the drops. If hypersensitivity develops the label directs discontinuation, and if inflammation or pain persists beyond 48 hours or worsens the patient is told to stop and see a doctor. For an allergic reaction to neomycin, patch testing identifies the culprit so it can be avoided in future - and in three-quarters of sensitised patients other allergens in creams and emollients were involved too. (Source 9)

Why might someone be low in it or missing it?

Nobody is naturally deficient in these drugs. Reasons not to use the product include its contraindications - most viral corneal and conjunctival disease including dendritic herpes simplex keratitis, vaccinia, varicella, mycobacterial eye infection and fungal eye disease, and known hypersensitivity to any ingredient or to other corticosteroids. It also has not been established as safe and effective in children under 2, and prescribing is deliberately restricted by the 20 mL cap and refill rule. (Source 21)

Which whole foods contain it or feed it?

No food contains or supplies these drugs and no food or supplement interaction has been documented for the eye preparation. The only dietary-adjacent pathway with any basis is that strong CYP3A4 inhibitors slow dexamethasone clearance, which the label links to Cushing's syndrome and adrenal suppression in predisposed people - stated as a class effect, with no named food. (Source 6)

We searched: Europe PMC for interactions of ophthalmic dexamethasone, neomycin or polymyxin B with food, alcohol, grapefruit, St John's wort and other supplements; and the full September 2024 product label, which names no food, alcohol or supplement interaction.

What happens if you do not have it?

For acute bacterial conjunctivitis, most people get better without any antibiotic: 55.5% of placebo-treated participants had resolved by days 4 to 9, against 68.2% on antibiotic, so going without costs speed rather than cure. For chronic ear discharge, leaving out the steroid specifically costs nothing detectable. For an inflamed eye that genuinely needs a steroid, the inflammation is what goes untreated, and the label lists conditions such as chronic anterior uveitis and chemical or thermal corneal burns where steroids are indicated. (Source 3)

How can you test for it?

Two tests matter, and neither measures the drug itself. Intraocular pressure must be monitored once the drops have been used for 10 days or longer, because the steroid can raise it; the label notes this is difficult in children and uncooperative patients. For suspected allergy, patch testing with the European baseline series, read at 48 hours, is the established method and is how the 2.29% neomycin sensitisation figure was obtained; it is a validated diagnostic test but a referral-population one, so the percentages reflect patients suspected of contact dermatitis rather than the general public. (Source 8)

References

1. DailyMed. MAXITROL (neomycin and polymyxin B sulfates and dexamethasone ophthalmic suspension) - FDA prescribing information, label revised September 2024 (Clinical Pharmacology). 2024. Read the source
2. DailyMed / Novartis-Sandoz (Alcon) listing. MAXITROL (neomycin and polymyxin B sulfates and dexamethasone ophthalmic suspension) - FDA prescribing information, label revised September 2024 (Indications and Usage). 2024. Read the source
3. The Cochrane database of systematic reviews. Antibiotics versus placebo for acute bacterial conjunctivitis. (Main results). 2023. PMID 36912752, DOI 10.1002/14651858.cd001211.pub4. Read the source
4. The Cochrane database of systematic reviews. Interventions for acute otitis externa. (Main results). 2010. PMID 20091565, DOI 10.1002/14651858.cd004740.pub2. Read the source
5. The Cochrane database of systematic reviews. Topical antibiotics with steroids for chronic suppurative otitis media. (Main results, comparison 2). 2025. PMID 40484406, DOI 10.1002/14651858.cd013054.pub3. Read the source
6. DailyMed. MAXITROL (neomycin and polymyxin B sulfates and dexamethasone ophthalmic suspension) - FDA prescribing information, label revised September 2024 (Dosage and Administration; Cushing's syndrome statement). 2024. Read the source
7. DailyMed. MAXITROL (neomycin and polymyxin B sulfates and dexamethasone ophthalmic suspension) - FDA prescribing information, label revised September 2024 (Warnings: neomycin sensitization). 2024. Read the source
8. Contact Dermatitis. Prevalence and Determinants of Sensitisation to Neomycin in North-Eastern Italy, 1997-2021. 2025. PMID 39778913, DOI 10.1111/cod.14730. Read the source
9. DailyMed. MAXITROL (neomycin and polymyxin B sulfates and dexamethasone ophthalmic suspension) - FDA prescribing information, label revised September 2024 (Precautions: IOP monitoring, overgrowth of non-susceptible organisms). 2024. Read the source
10. DailyMed. MAXITROL (neomycin and polymyxin B sulfates and dexamethasone ophthalmic suspension) - FDA prescribing information, label revised September 2024 (Dosage and Administration). 2024. Read the source
11. DailyMed. MAXITROL (neomycin and polymyxin B sulfates and dexamethasone ophthalmic suspension) - FDA prescribing information, label revised September 2024 (Warnings: corticosteroid risks). 2024. Read the source
12. DailyMed. MAXITROL (neomycin and polymyxin B sulfates and dexamethasone ophthalmic suspension) - FDA prescribing information, label revised September 2024 (Adverse Reactions). 2024. Read the source
13. American journal of ophthalmology. Antibiotics Versus Placebo for Acute Bacterial Conjunctivitis: Findings From a Cochrane Systematic Review.. 2024. PMID 37482371, DOI 10.1016/j.ajo.2023.06.027. Read the source
14. The Cochrane database of systematic reviews. Topical antibiotics with steroids for chronic suppurative otitis media. (Main results, comparison 1). 2025. PMID 40484406, DOI 10.1002/14651858.cd013054.pub3. Read the source
15. The Cochrane database of systematic reviews. Topical antibiotics with steroids for chronic suppurative otitis media.. 2025. PMID 40484406, DOI 10.1002/14651858.cd013054.pub3. Read the source
16. DailyMed. MAXITROL (neomycin and polymyxin B sulfates and dexamethasone ophthalmic suspension) - FDA prescribing information, label revised September 2024 (Precautions: Carcinogenesis, Mutagenesis, Impairment of Fertility; Pregnancy). 2024. Read the source
17. The Cochrane database of systematic reviews. Topical antibiotics for chronic suppurative otitis media. (Main results, comparison 3). 2025. PMID 40484407, DOI 10.1002/14651858.cd013051.pub3. Read the source
18. The Cochrane database of systematic reviews. Topical antibiotics for chronic suppurative otitis media.. 2025. PMID 40484407, DOI 10.1002/14651858.cd013051.pub3. Read the source
19. DailyMed. MAXITROL (neomycin and polymyxin B sulfates and dexamethasone ophthalmic suspension) - FDA prescribing information, label revised September 2024 (Description: composition). 2024. Read the source
20. Contact Dermatitis. Prevalence and Determinants of Sensitisation to Neomycin in North-Eastern Italy, 1997-2021 (Background). 2025. PMID 39778913, DOI 10.1111/cod.14730. Read the source
21. DailyMed. MAXITROL (neomycin and polymyxin B sulfates and dexamethasone ophthalmic suspension) - FDA prescribing information, label revised September 2024 (Contraindications). 2024. Read the source