Neomycin is the most ototoxic of the aminoglycosides and it is now rarely used, except in topical preparations; even this use is discouraged because of the risk of promoting the emergence of aminoglycoside resistance. It has also been admnistered orally together with other agents to sterilize the gut before abdominal surgery, but the inactivity of aminoglycosides against anaerobes ensures that most of the gut flora escapes, and the procedure is not without risk of systemic toxicity. Framycetin, a common component of topical preparations, is identical to neomycin B.
One aminoglycoside of the neomycin group, paromomycin, is unusual in exhibiting activity against the protozoa causing amoebic dysentery and leishmaniasis as well as some tapeworms.


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