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Polymyxin b sulfate + bacitracin zinc + hydrocortisone acetate + neomycin is an approved fixed-dose ophthalmic combination product comprising three topical antibiotics and a corticosteroid. Neomycin is an aminoglycoside that inhibits bacterial protein synthesis by binding the bacterial ribosome, polymyxin b disrupts the outer membrane of susceptible Gram-negative bacteria, and bacitracin inhibits bacterial cell wall synthesis; hydrocortisone acetate provides local anti-inflammatory corticosteroid activity through glucocorticoid receptor signaling. The ointment has been marketed under brand names including Cortisporin Ophthalmic Ointment and Neo-Polycin HC Ophthalmic Ointment for steroid-responsive inflammatory ocular conditions in which bacterial infection is present or there is a risk of bacterial infection, including inflammatory disorders of the palpebral and bulbar conjunctiva, cornea, and anterior segment of the globe, chronic anterior uveitis, infective conjunctivitis, and corneal injury from chemical, radiation, or thermal burns or foreign bodies. It is a topical ophthalmic small-molecule pharmaceutical product historically associated with Pfizer and is active against common ocular pathogens such as Staphylococcus aureus, Streptococcus pneumoniae, Escherichia coli, Haemophilus influenzae, Klebsiella and Enterobacter species, Neisseria species, and Pseudomonas aeruginosa.
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