Neomycin
By killing bacteria in the intestinal tract, Neomycin keeps ammonia levels low and prevents hepatic encephalopathy, especially before gastrointestinal surgery.Neomycin is not administered via injection, as it is extremely nephrotoxic (damaging to kidney function) even when compared to other aminoglycosides.[6] In 2022, the combination of neomycin with dexamethasone and polymyxin B was the 274th most commonly prescribed medication in the United States, with more than 800,000 prescriptions.[10] The following represents minimum inhibitory concentration (MIC) susceptibility data for a few medically significant Gram-negative bacteria.[14] Like other aminoglycosides, neomycin has been shown to be ototoxic, causing tinnitus, hearing loss, and vestibular problems in a small number of patients.[15] Hearing loss is caused by ear hair cell death, which occurs in response to treatment with neomycin.[15] Patients with existing tinnitus or sensorineural hearing loss are advised to speak with a healthcare practitioner about the risks and side effects prior to taking this medication.[18] Genes conferring neomycin-resistance are commonly included in DNA plasmids used to establish stable mammalian cell lines expressing cloned proteins in culture.[22] A deacetylase acting to remove the acetyl group on N-acetylglucosamine moieties of aminoglycoside intermediates (Neo16) remains to be clarified (sequence similar to BtrD).
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