hydrocortisone acetate + bacitracin + colistin

Hydrocortisone acetate + bacitracin + colistin (marketed as Bacicoline-B) is a topical ototopical combination drug formulation consisting of two antibiotics—bacitracin and colistin (as colistimethate sodium)—and the corticosteroid hydrocortisone acetate. It is indicated for the treatment of otorrhea in patients with otitis media in the presence of tympanic membrane perforation or tympanostomy tubes, including acute tympanostomy tube otorrhea (ATTO) in children. The drug acts through a multi-pronged mechanism: bacitracin inhibits bacterial cell wall synthesis by binding to C55-isoprenyl pyrophosphate; colistin disrupts bacterial cell membrane integrity by binding to lipopolysaccharides (LPS); and hydrocortisone acetate reduces inflammation by activating glucocorticoid receptors. Clinical evidence, including a Phase 4 randomized trial conducted in the Netherlands, has demonstrated that these eardrops are superior to oral antibiotics and watchful waiting for the resolution of otorrhea in children with ATTO. The product is primarily available in European markets, including the Netherlands and France.

Brand names

Bacicoline-B

Other names

Bacicolinehydrocortisone-bacitracin-colistincolistimethate sodium + bacitracin + hydrocortisone acetate