I. Contraindications
- Patients allergic to aminoglycoside antibiotics such as Streptomycin, Kanamycin, Gentamycin, and Neomycin.
- Skin tuberculosis, herpes simplex, chickenpox, herpes zoster, and vaccinia.
- Patients allergic to Triamcinolone.
- Eczematous otitis externa with tympanic membrane perforation.
- Ulcers, second-degree burns or higher, and frostbite.
II. Warnings and Precautions
- In principle, confirm bacterial susceptibility before use to prevent the development of resistant bacteria and achieve therapeutic goals in the shortest time and with the lowest possible dose.
- Pregnancy: Use by pregnant women: The safety of use in pregnant women has not been established. Avoid prolonged and high-dose use by pregnant women or women who may become pregnant. Children: Use by young children: Long-term continuous use may affect development.
General Precautions: Rare allergic reactions such as itching, redness, swelling, papules, and small blisters may occur. If these occur, discontinue use immediately. Avoid prolonged continuous use on extensive burns or ulcerated skin. If the therapeutic effect is not achieved, use in conjunction with or with other antibacterial or antifungal agents. Large-volume or prolonged extensive use of occlusive therapy (ODT) has the same side effects as systemic corticosteroid administration. Prolonged or inappropriate use of topical corticosteroids can lead to rebound reactions (topical steroid withdrawal) after treatment cessation. Severe rebound reactions may extend beyond the initial treatment site, and symptoms may include dermatitis with intense redness, stinging, and burning sensations, especially when used on more delicate skin areas such as the face and curved areas. If the above symptoms reappear within days to weeks after successful treatment, a rebound effect should be suspected. If topical corticosteroids need to be used again, carefully assess their clinical benefits and risks, or consider alternative treatment options. Elderly individuals should use with caution due to declining physiological function. Note: Do not use in ophthalmology.
III. Precautions for Special Groups
IV. Side Effects / Adverse Reactions
Clinically Important Side Effects / Adverse Reactions:
- To avoid side effects on the kidneys and auditory nerve, prolonged use should be avoided.
- Skin Infections: When fungal (candidiasis, tinea capitis, etc.) and bacterial (impetigo, folliculitis, etc.) skin infections occur (most commonly caused by occlusive treatment (ODT), other antifungal and antibacterial agents should be used appropriately. If symptoms do not improve rapidly, use should be discontinued.
- Skin and Subcutaneous Tissue Diseases • Withdrawal Reactions (frequency unknown): Skin redness, which may spread beyond the initial treatment area, burning or stinging sensation, itching, skin peeling, and oozing.
Other skin symptoms: Long-term continuous use may lead to adrenal cortical acne (a tendency to develop white pimples similar to acne vulgaris), adrenal cortical rosacea and perioral inflammation (perioral and rare facial erythema, papules, telangiectasia, crusting, and scaling), and adrenal cortical dermatitis (skin atrophy, telangiectasia). Ichthyosis-like skin changes such as purpura, hirsutism, and depigmentation are rare. If these occur, a medication without adrenal cortex should be used. Allergic reactions: Skin irritation and rashes are rare. If these occur, use should be discontinued. Pituitary gland and adrenal cortex function: Large doses or prolonged, widespread use of the occlusive therapy (ODT) may suppress pituitary gland and adrenal cortex function; caution should be exercised. Eyes: Eyelid skin. When using this treatment, be aware of the risk of increased intraocular pressure and the development of chlorosis. When using extensive or prolonged ODT (Obstructive Closed Therapy) treatment, be aware of the risk of cataracts and chlorosis.
