Aflumycin (Prednisolone and gentamicin) is used as eye drops or ointments for the treatment of superficial inflammatory conditions of the eyes. It is a combination of an antibiotic and corticosteroid.

Prednisolone and gentamicin Uses:

• Inflammatory ocular conditions and superficial ocular infections:

  • It is indicated for the treatment of inflammatory conditions of the eyes with mild superficial bacterial infection or where the risk of bacterial infection exists.

Aflumycin (Prednisolone and gentamicin) Dose in Adults

Aflumycin (Prednisolone and gentamicin) Dose in the treatment of Inflammatory conditions and superficial ocular infections: Ophthalmic:

• Ointment:
  • Apply a half-inch ribbon of the ointment into the conjunctival sac of the affected eye(s) 1 to 3 times a day.
• Suspension:
  • Instill a single drop into the conjunctival sac of the affected eye(s) 2 to 4 times a day.
  • The dosing frequency may be increased during the first two days if required up to one drop hourly.

Note: If there is not improvement within 48 hours, the patient should be re-evaluated.

Dose in Children:

Not indicated.

Pregnancy Risk Factor C

• This combination has not been used in animal reproduction studies.
• Talk to individual agents.

Use of prednisolone or gentamicin while breastfeeding

• It is not known if breastmilk contains enough drug to excrete it.
• The manufacturer suggests that infants stop breastfeeding because of the risk of serious adverse drug reactions.

• See individual agents.

Dose in Kidney disease:

There are no dosage adjustments provided in the manufacturer's labeling

Dose in Liver disease:

There are no dosage adjustments provided in the manufacturer's labeling

Side effects of Aflumycin (Prednisolone and gentamicin):

• Dermatologic:

  • Contact Dermatitis
  • Skin Rash

• Gastrointestinal:

  • Dysgeusia

• Hypersensitivity:

  • Angioedema
  • Hypersensitivity Reaction

• Ophthalmic:

  • Allergic Conjunctivitis
  • Blurred Vision
  • Burning Sensation Of Eyes
  • Eye Discharge
  • Eye Irritation
  • Eye Pain
  • Foreign Body Sensation Of Eye
  • Increased Lacrimation
  • Ocular Edema
  • Ocular Hyperemia
  • Stinging Of Eyes
  • Superficial Punctate Keratitis
  • Visual Impairment

Contraindications to Aflumycin (Prednisolone and gentamicin):

• Allergy to gentamicin or prednisolone, corticosteroids or any component of formulation
• Viral infection of the cornea or conjunctiva. Also known as herpes simplex, vaccinia and varicella infections.
• Mycobacterial and fungal infections of the eyes.

Warnings and precautions

• Infection

  • As a result, steroids can cause serious infections like fungal or bacterial superinfections. Steroids may mask symptoms of undiagnosed herpes commonx infection.

• Ocular effects

  • It has been associated with irritation and puncttate keratitis. It has been linked to glaucoma, optic nerve injury, impaired visual acuity, visual field defects, corneal scarring, and thinning, which can lead to perforation and subcapsular cataract formation.

• Glaucoma:

  • Patients with glaucoma should use it with caution. Patients should also have their intraocular pressure checked frequently, especially during extended therapy.

• Ocular herpes simplex

  • Patients with active herpes infection should avoid it. Patients with a history should not use it. It is recommended to use slit lamp microscopy frequently.

Prednisolone and gentamicin: Drug Interaction

Monitoring Parameters:

Monitor for the response to treatment. If clinical worsening is noted (as may occur in undiagnosed viral keratitis), treatment should be immediately discontinued.

How to administer Aflumycin (Prednisolone and gentamicin)?

Note:

• Avoid wearing contact lenses during the treatment. Also, avoid contaminating the eye drops by not touching the tip of the bottle with eyes or other surfaces.

Ointment:

• Apply the ointment inside the lower conjunctival sac between the eyeball and lower lid. The patients should be looking downward before closing the eyes while applying the ointment.

Suspension:

• The suspension should be shaken well before using it. Tilt the head back and instill the drops into the conjunctival sac and close the eyes.
• To minimize distaste and systemic exposure, place one finger over the lacrimal sac and apply light pressure for a minute after instilling the drops.

Mechanism of action of Prednisolone and gentamicin:

Gentamicin:

• It is an aminoglycoside antibacterial that inhibits bacterial growth and interferes with bacterial protein production. 
• It does this by binding to the 30S ribosomal Subunits, resulting in the formation of a defective bacterial cell wall.

Prednisolone:

• It is a corticosteroid which reduces inflammation by inducing edema, leukocyte movement, inhibiting capillary proliferation and dilation, collagen formation, fibrin deposition and scar formation.

Refer to individual agents (Gentamicin or Prednisolone).

International Brand Names of Prednisolone and gentamicin:

• Pred-G
• Aflumycin
• Inflanegent
• Pharogentone

Prednisolone and gentamicin Eye Drops Brand Names in Pakistan: