Atracurium + Bacitracin-neomycin-polymyxin

MediHelp rates the interaction as major. Atracurium and Bacitracin-neomycin-polymyxin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Systemically absorbed polymyxin B and neomycin can have neuromuscular blocking activity and may potentiate non-depolarizing blockers. This could cause prolonged paralysis and respiratory depression. The risk with topical or irrigation use is low unless there is significant absorption from large wounds, body cavities or irrigation.

MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid peritoneal or wound irrigation with these antibiotics around anesthesia where possible. Monitor neuromuscular function and be prepared for ventilatory support, noting that calcium may be needed for reversal.

MediHelp also lists interactions of Bacitracin-neomycin-polymyxin with, for example, Allogeneic cultured keratinocytes / fibroblasts in bovine collagen, Capreomycin, Cidofovir. The full list is on the Bacitracin-neomycin-polymyxin page.