Topical/Cutaneous Corticosteroid-responsive dermatoses with secondary infection
Adult: Available preparation:
Betamethasone 0.5 mg (0.05%) and gentamicin 1 mg (0.1%) cream or ointment
Apply a thin film onto affected area bid. Duration of treatment varies according to patient response and extent and location of disease. Reassess diagnosis, if no clinical improvement after 3-4 weeks.
Hypersensitivity. Viral diseases (e.g. varicella, herpes simplex, vaccinia), TB of the skin.
Pregnancy and lactation.
Significant: Adrenal suppression (particularly when used in younger children or patients receiving high doses for prolonged periods), allergic contact dermatitis, hypersensitivity reactions, local sensitisation (redness, irritation), secondary bacterial or fungal superinfection (prolonged use), visual disturbances (e.g. blurred vision), posterior subcapsular cataracts, glaucoma, hyperglycaemia, glycosuria; delayed weight gain, intracranial hypertension, growth retardation in children. Rarely, Cushing syndrome, central serous chorioretinopathy. Skin and subcutaneous tissue disorders: Rash, dryness, burning, itching, folliculitis, hypertrichosis, acneiform eruptions, hypopigmentation, perioral dermatitis, skin atrophy, striae, miliaria, maceration of the skin.
Monitor HPA axis suppression and adrenal insufficiency (particularly in children), ocular symptoms.
Betamethasone: May suppress the flare and wheal reactions to skin test antigens.
Description: Mechanism of Action: Betamethasone is a corticosteroid that has anti-inflammatory, antipruritic, and vasoconstrictive actions. It induces the phospholipase A2 inhibitory proteins (lipocortins) and sequentially inhibits the release of arachidonic acid, thus leading to reduction of the formation, release, and activity of endogenous chemical mediators of inflammation (e.g. kinins, histamine, prostaglandins, liposomal enzymes).
Gentamicin is a broad-spectrum aminoglycoside antibiotic which interferes with the bacterial protein synthesis by binding to the 30S and 50S ribosomal subunit of susceptible bacteria, thus rendering the bacterial cell membrane defective. Pharmacokinetics: Absorption: Betamethasone: Absorbed percutaneously (variable).
Gentamicin: Absorbed (systemic) following topical administration on denuded skin and burns. Metabolism: Betamethasone: Metabolised in the liver. Excretion: Betamethasone: Via urine and bile.