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Neomycin sulfate + polymyxin b sulfate is a **combination of two antibiotics**—neomycin sulfate (an aminoglycoside) and polymyxin B sulfate (a polypeptide). This combination is included in various formulations, most commonly as ophthalmic or otic solutions, ointments, and suspensions, for the treatment and prevention of superficial infections caused by susceptible bacteria. - **Neomycin sulfate** acts by binding to bacterial ribosomal RNA, causing misreading of mRNA and inhibiting protein synthesis, ultimately leading to bacterial cell death. - **Polymyxin B sulfate** interacts with the phospholipids of the bacterial cell membrane of Gram-negative bacteria, increasing membrane permeability and causing cell lysis. The combination is active against a range of bacteria, including *Staphylococcus aureus*, *Escherichia coli*, *Haemophilus influenzae*, *Klebsiella/Enterobacter* species, *Neisseria* species, and *Pseudomonas aeruginosa*, but lacks adequate coverage for *Serratia marcescens* and many streptococci[1][2]. Indications include superficial bacterial infections (skin, eye, and ear) and prevention of infection in minor skin injuries.
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