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Polymyxin b sulfate + bacitracin zinc + lidocaine hydrochloride + neomycin is a fixed-dose topical anti-infective and local-anesthetic combination. Polymyxin B disrupts susceptible Gram-negative bacterial outer membranes through lipopolysaccharide binding; bacitracin inhibits bacterial cell-wall synthesis by interfering with the undecaprenyl phosphate carrier cycle; neomycin inhibits bacterial protein synthesis through the 30S ribosomal subunit; and lidocaine reversibly blocks voltage-gated sodium channels to provide local analgesia. United States OTC cream and ointment products containing this four-active combination are labeled for prevention of infection and temporary relief of pain or discomfort in minor cuts, scrapes, and burns. ([dailymed.nlm.nih.gov](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=8902aa55-547d-787f-e053-2a95a90a2289))
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