Keto 4S Cream is a topical formulation combining Ofloxacin (0.75% w/w), Ornidazole (2% w/w), Terbinafine (1% w/w), and Mometasone (0.1% w/w), designed for the treatment of mixed bacterial, protozoal, fungal infections, and inflammatory dermatoses. Ofloxacin, a fluoroquinolone antibiotic, provides broad-spectrum antibacterial activity against gram-positive and gram-negative bacteria. Ornidazole, a nitroimidazole derivative, exhibits potent antiprotozoal and anaerobic antibacterial effects, making it effective against protozoal infections and anaerobic bacteria. Terbinafine, an allylamine antifungal agent, inhibits fungal cell membrane synthesis, targeting dermatophytes and other pathogenic fungi. Mometasone furoate, a potent corticosteroid, exerts anti-inflammatory, antipruritic, and vasoconstrictive actions, reducing inflammation and associated symptoms such as redness and itching. The combination of these agents in Keto 4S Cream allows for comprehensive management of complex skin infections accompanied by inflammation, including mixed bacterial and fungal infections with secondary inflammation. It is indicated for conditions such as tinea infections complicated by bacterial superinfection and inflammatory dermatoses requiring antimicrobial and anti-inflammatory therapy. Application should be as directed by a healthcare professional, with caution advised to avoid prolonged use due to the corticosteroid component. Adverse effects may include local irritation or hypersensitivity reactions. Use is contraindicated in viral skin infections and in patients with known hypersensitivity to any component.