Clobetasol with Neomycin and Nystatin

This combination preparation contains clobetasol propionate, neomycin sulphate, and nystatin.

Clobetasol is a very potent (superpotent) topical corticosteroid, neomycin is an aminoglycoside antibiotic, and nystatin is an antifungal.

It is prescribed for severe inflammatory skin conditions where both bacterial and fungal infection are present or strongly suspected.

The very potent corticosteroid rapidly suppresses the intense inflammation, redness, itching, and thickening that characterise severe eczema, psoriasis, or dermatitis flares.

Neomycin provides cover against common skin bacteria such as Staphylococcus aureus, which frequently colonise or infect damaged skin, while nystatin addresses concurrent Candida infection.

This triple combination is particularly useful in cases where secondary infection complicates an already severe dermatological condition.

Due to the very potent nature of clobetasol, this preparation is reserved for short-term use under close medical supervision.

Treatment duration should be limited, and patients should be stepped down to less potent therapies as soon as clinically possible.

Apply a thin layer to the affected area once or twice daily, as directed by your prescriber. Gently rub into the skin. Do not apply to the face, groin, or axillae unless specifically instructed.

Do not cover with airtight dressings. Wash your hands thoroughly after application.

Treatment should be reviewed within two weeks.

If there is good improvement, your doctor will step down to a less potent steroid, possibly without the antimicrobial components, to continue managing the condition.

Apply sparingly to affected areas once or twice daily. Treatment courses should generally not exceed two weeks on any one site.

The total weekly amount of clobetasol-containing preparations should not exceed 50 g. If the condition requires longer treatment, a less potent steroid should be substituted.

Children should only be treated under specialist supervision.

Common local effects include burning or stinging on application. Prolonged use of clobetasol may cause marked skin thinning, striae, telangiectasia, perioral dermatitis, and acneiform eruptions.

Neomycin may cause allergic contact dermatitis in sensitised individuals, particularly with prolonged use.

Systemic absorption of clobetasol can suppress the hypothalamic-pituitary-adrenal axis, especially when applied to large areas, under occlusion, or for extended periods.

Nystatin rarely causes adverse effects topically.

This is a very potent steroid preparation and must be used under close medical supervision. Avoid application to the face, eyelids, and genital area unless specifically directed.

Do not use under occlusive dressings. If the infection does not respond to treatment, consider bacterial resistance to neomycin.

Monitor for signs of neomycin sensitisation (worsening rather than improving eczema).

Children are particularly susceptible to adrenal suppression from topical steroids and should be monitored carefully.

Contraindicated in patients with untreated viral skin infections (herpes, chickenpox, shingles), tuberculosis of the skin, rosacea, acne vulgaris, perioral dermatitis, and known hypersensitivity to clobetasol, neomycin, nystatin, or any excipient.

Not suitable for use on the face or in children under one year. Patients with known neomycin allergy must not use this product.