betamethasone + gentamicin

Action and Spectrum

Actions and Spectrum: 

• betamethasone is a synthetic corticosteroid. Its primary mechanism of action is anti-inflammatory and immunosuppressive. When applied topically, it works by binding to glucocorticoid receptors in skin cells, modulating gene expression, and suppressing the inflammatory response. This reduces redness, itching, and swelling associated with various skin conditions. 
• gentamicin is an antibiotic that belongs to the aminoglycoside class. Its mechanism of action involves inhibiting bacterial protein synthesis. gentamicin binds to the bacterial ribosome, disrupting the production of essential proteins needed for bacterial growth and replication. This antibacterial action helps prevent or treat bacterial infections in the skin. 
• betamethasone’s activity is limited to its anti-inflammatory and immunosuppressive effects. It does not have direct antibacterial or antifungal properties. 
• gentamicin primarily targets gram-negative bacteria, including strains such as Escherichia coli, Pseudomonas aeruginosa, and Klebsiella pneumoniae. It is less effective against gram-positive bacteria and does not have antifungal or antiviral properties. 

Drug Interaction

Adverse Reaction

Frequency not defined 

Hypersensitivity reactions 

Local sensitization 

Allergic contact dermatitis 

Rash 

Dryness 

Burning 

Folliculitis 

Hypertrichosis 

Acneiform eruptions 

Hypopigmentation striae 

Maceration of the skin 

Black Box Warning

Black box warning: 

None 

Contraindication / Caution

Contraindications/caution: 

Contraindications: 

• Hypersensitivity or Allergy: Patients with a known hypersensitivity or allergy to betamethasone, gentamicin, or any other ingredients in the medication should not use it. Allergic reactions can range from mild skin irritation to severe allergic dermatitis. 
• Fungal or Viral Skin Infections: This combination medication is inappropriate for treating fungal or viral skin infections (such as herpes or chickenpox). It can exacerbate some viral infections and should be avoided in such cases. 
• Tuberculosis of the Skin: If a patient has skin tuberculosis, corticosteroids like betamethasone can worsen the condition. It is essential to rule out tuberculosis before using this medication. 
• Perioral Dermatitis: betamethasone can exacerbate perioral dermatitis, a skin condition characterized by redness and bumps around the mouth and nose. The use of topical corticosteroids like betamethasone in these cases is generally contraindicated. 
• Acne Vulgaris: Topical corticosteroids like betamethasone can worsen acne, so it is typically contraindicated in cases of acne vulgaris. 
• Rosacea: betamethasone can exacerbate rosacea symptoms, a chronic skin condition characterized by facial redness and visible blood vessels. Therefore, its use should be avoided in patients with rosacea. 

Pregnancy / Lactation

Pregnancy consideration: N/A 

Lactation: N/A 

Pregnancy category: 

Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester. 

Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women. 

Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.    

Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.    

Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.    

Category N: There is no data available for the drug under this category 

Pharmacology

Pharmacology: 

Combining betamethasone and gentamicin in a topical medication offers a dual pharmacological approach to address inflammation and bacterial infections in various skin conditions. betamethasone addresses inflammation and immune responses in the skin, while gentamicin targets bacterial infections that may coexist with the underlying skin condition. 

Pharmacokinetics: 

Absorption 

betamethasone can be absorbed percutaneously (through the skin). Still, the extent of absorption can vary depending on factors such as the formulation of the medication, the condition of the skin, and the duration of contact. Absorption through intact skin is generally limited compared to inflamed or damaged skin. 

gentamicin can be absorbed systemically following topical administration, mainly when applied to denuded (injured or damaged) skin and burns. This increased absorption can result in detectable levels of gentamicin in the bloodstream. 

Metabolism 

betamethasone is metabolized primarily in the liver. Metabolism is essential in breaking down the drug for elimination from the body. 

Elimination and Excretion 

betamethasone and its metabolites are excreted from the body via both urine and bile. Excretion through the urine and bile is part of the process by which the drug is eliminated from the body. 

Adminstartion

Administration: 

Topical administration 

Apply a thin, even layer of the combined betamethasone and gentamicin cream or ointment to the affected area. 

Patient Information Leaflet

Patient information leaflet 

Generic Name: betamethasone + gentamicin 

Why do we use betamethasone + gentamicin? 

The combination of betamethasone and gentamicin in a topical medication is typically prescribed for various skin conditions where inflammation and bacterial infection coexist.  

• Infected Dermatitis: This combination medication can treat various forms of dermatitis (skin inflammation), such as atopic dermatitis (eczema) or contact dermatitis, when there is a risk of bacterial infection or a secondary bacterial infection. 
• Psoriasis with Bacterial Infection: It may be prescribed for individuals with psoriasis who have developed a bacterial infection on their skin. betamethasone addresses psoriatic inflammation, while gentamicin targets bacterial infection. 
• Eczema with Superinfection: When eczema becomes infected with bacteria, combining betamethasone and gentamicin can help reduce inflammation and simultaneously treat the bacterial infection. 
• Impetigo: Impetigo is a highly contagious bacterial skin infection. This combination of medications can treat impetigo lesions by reducing inflammation and eradicating the bacterial infection. 
• Folliculitis: Folliculitis is an infection of hair follicles that can be itchy and painful. The combination can be used to alleviate symptoms and treat the bacterial component of the condition.