nystatin + neomycin + polymyxin B

**nystatin + neomycin + polymyxin B** is a fixed-dose combination of two antibiotics (neomycin, an aminoglycoside; polymyxin B, a polypeptide) and one antifungal agent (nystatin, a polyene). It is used as a broad-spectrum empirical therapy for the local (vaginal) treatment of infectious vaginitis and related conditions, including those with mixed bacterial and fungal (often Candida albicans) etiologies. Neomycin inhibits bacterial protein synthesis by binding to the 30S ribosomal subunit, while polymyxin B disrupts Gram-negative bacterial cell membranes via interaction with lipopolysaccharides, leading to cell death. Nystatin binds to ergosterol in fungal cell membranes, increasing their permeability and causing cell death. The combination covers most common fungal and bacterial pathogens implicated in vaginitis, including cases where the causative agent is not initially identified. Its rapid bactericidal and fungicidal actions make it effective for both aerobic and anaerobic bacteria, as well as for Candida species.

Brand names

PolygynaxNystoval

Other names

NNP combinationneomycin-polymyxin B-nystatinNystatin-Neomycin-Polymyxin B Combination