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Discovery and Properties
- Discovered in 1949 by microbiologist Selman Waksman and student Hubert Lechevalier at Rutgers University
- Produced naturally by the bacterium Streptomyces fradiae
- Synthesis requires specific nutrient conditions in either stationary or submerged aerobic conditions
- Isolated and purified from the bacterium
- Neomycin was discovered over 50 years ago
- Neomycin is an antibiotic active against streptomycin-resistant bacteria
- It has been used in pharmaceutical manufacturing
- Neomycin can induce hypersensitivity reactions in some individuals

Medical Uses
- Typically applied topically, such as in Neosporin
- Can be administered orally, often combined with other antibiotics
- Used as a preventive measure for hepatic encephalopathy and hypercholesterolemia
- Effective against streptomycin-resistant bacteria and Mycobacterium tuberculosis
- Used to treat small intestinal bacterial overgrowth

Spectrum
- Excellent activity against gram-negative bacteria
- Partially effective against gram-positive bacteria
- Relatively toxic to humans, with allergic reactions as a common adverse reaction
- Physicians sometimes recommend antibiotic ointments without neomycin
- Minimum inhibitory concentration (MIC) susceptibility data for medically significant gram-negative bacteria

Side Effects
- Fifth-most-prevalent allergen in patch test results
- Known GABA antagonist, responsible for seizures and psychosis
- Ototoxic, causing tinnitus, hearing loss, and vestibular problems
- Affects the cochlea in the inner ear
- Patients with existing tinnitus or hearing loss should consult a healthcare practitioner

Molecular Biology
- Antibacterial activity through binding to the 30S subunit of the prokaryotic ribosome
- High binding affinity for phosphatidylinositol 4,5-bisphosphate (PIP2)
- Resistance conferred by kanamycin kinase genes
- Neomycin-resistant bacteria research ongoing
- Biosynthetic pathway and composition of neomycin

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