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**bacitracin zinc + neomycin sulfate + hydrocortisone + polymyxin b** is an FDA-approved ophthalmic combination ointment composed of three topical antibiotics and one corticosteroid, historically marketed as **Cortisporin Ophthalmic Ointment** and now available as a generic from multiple manufacturers. It is used for steroid-responsive inflammatory ocular conditions when bacterial infection is present or there is significant risk of infection, including inflammatory conditions of the palpebral and bulbar conjunctiva, cornea, and anterior segment of the globe, as well as infective conjunctivitis, chronic anterior uveitis, and corneal injury from chemical, thermal, or radiation burns or foreign body penetration. Bacitracin inhibits bacterial cell wall synthesis, neomycin binds the bacterial 30S ribosomal subunit to inhibit protein synthesis, polymyxin b disrupts bacterial cell membrane integrity, and hydrocortisone activates glucocorticoid receptors to suppress inflammatory responses. The product provides broad coverage against common bacterial eye pathogens such as *Staphylococcus aureus*, streptococci including *Streptococcus pneumoniae*, *Escherichia coli*, *Haemophilus influenzae*, *Klebsiella/Enterobacter* species, *Neisseria* species, and *Pseudomonas aeruginosa*, but not adequate coverage against *Serratia marcescens*.
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