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Neomycin + metronidazole is a combination of two antibiotics used primarily for the reduction of colonic bacterial flora prior to elective colorectal surgery. Neomycin is an aminoglycoside antibiotic that acts by inhibiting protein synthesis in bacteria, mainly targeting aerobic Gram-negative organisms. Metronidazole is a nitroimidazole antibiotic effective against anaerobic bacteria and certain protozoa; it works by disrupting DNA synthesis in susceptible organisms. The combination is administered orally and has been shown to significantly reduce both aerobic and anaerobic bacterial counts in the colon, thereby lowering the risk of postoperative wound infections and sepsis following bowel surgery[1][4][6][8][9]. This regimen may also be used as part of preoperative prophylaxis protocols alongside mechanical bowel preparation.
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