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Neomycin sulfate + hydrocortisone acetate + bacitracin zinc + polymyxin b is a sterile prescription **ophthalmic ointment** combining three antibacterial agents with the anti-inflammatory corticosteroid hydrocortisone acetate. Neomycin inhibits bacterial protein synthesis through binding to the bacterial 30S ribosomal subunit; polymyxin B disrupts susceptible Gram-negative bacterial outer membranes through interaction with lipopolysaccharide; and bacitracin interferes with bacterial cell-wall precursor transport. Hydrocortisone acetate activates glucocorticoid receptors to suppress ocular inflammation. The combination is used for steroid-responsive inflammatory conditions of the conjunctiva, cornea, and anterior segment when bacterial infection is present or a meaningful infection risk exists, including chronic anterior uveitis and corneal injury caused by chemical, radiation, or thermal burns or foreign-body penetration. It is marketed in the United States as Neo-Polycin HC ophthalmic ointment.
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