bacitracin topical

Bacitracin topical is an antibiotic ointment applied locally to prevent infection in minor skin injuries including cuts, scrapes, and burns. Bacitracin ointment is also used to treat superficial infections in the eye surface and eyelids.

Bacitracin is a mixture of several cyclic polypeptide antibiotics that prevents infection by both inhibiting the growth of bacteria (bacteriostatic) and killing bacteria (bactericidal) depending on the drug concentration and susceptibility of the organisms.

Bacitracin works by preventing the transfer of mucopeptides (peptidoglycans) to the bacterial cell wall. Mucopeptides are essential for providing structure and stability to the bacterial cell wall, and blocking their transfer inhibits cell wall synthesis and bacterial growth, resulting in the breakdown of bacterial cells. Bacitracin also inhibits proteases and other enzymes involved in bacterial cell membrane functions.

Bacitracin topical formulation is available over the counter (OTC), while ophthalmic ointment requires a prescription. Bacitracin is also commonly used as a part of combination antibiotics. Bacitracin is primarily effective against gram-positive bacteria and a few gram-negative bacteria, but most gram-negative bacteria are resistant to bacitracin. Gram-positive and gram-negative bacteria are structurally different and are identified by the Gram stain lab test. Gram-negative bacteria have an additional membrane outside the cell well that gram-positive bacteria lack.

Organisms susceptible to bacitracin include:

Staphylococcus species (including some penicillin G resistant strains), Streptococcus species, Corynebacterium species, Clostridium species, anaerobic cocci, gonococci, meningococci (Neisseria species), fusobacteria, Treponema pallidum, Treponema vincentii, and Actinomyces species.

• Do not use bacitracin in patients with known hypersensitivity to any of the components in the topical or ophthalmic formulations.
• Topical antibiotics are known to induce the immune system to overreact (contact sensitizers). There may be immediate or delayed immune reactions.
• Minor allergic skin reactions including rash and contact dermatitis, and serious hypersensitivity reactions including anaphylaxis have been reported with topical bacitracin.
• Patients sensitive to bacitracin may also have cross-sensitivity to polymyxin B, another antibiotic.
• Do not use bacitracin topical in the external ear canal if you have a perforated eardrum.
• Do not use OTC topical bacitracin formulation in the eyes, use only ophthalmic ointment.
• Do not use bacitracin ointment if you have hypersensitivity disorder (atopy).
• Do not use bacitracin topical for deep-seated eye infections or those that can become systemic.
• Prolonged use of topical or ophthalmic antibiotics can result in the overgrowth of nonsusceptible organisms, including fungi.

Common side effects of bacitracin topical include:

Topical:

• Rash
• Itching
• Pain
• Contact dermatitis
• Hypersensitivity reaction (rare)

Ophthalmic:

• Eye irritation
• Pain
• Burning
• Stinging and itching
• Blurred vision
• Nausea
• Diarrhea
• Rectal itching
• Loss of appetite (anorexia)
• Excessive sweating (diaphoresis)
• Blood disorders
• Hypersensitivity reaction

Call your doctor immediately if you experience any of the following symptoms or serious side effects while using this drug:

• Serious heart symptoms include fast or pounding heartbeats, fluttering in your chest, shortness of breath, and sudden dizziness;
• Severe headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady;
• Severe nervous system reaction with very stiff muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, and feeling like you might pass out; or
• Serious eye symptoms include blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights.

This is not a complete list of all side effects or adverse reactions that may occur from the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may also report side effects or health problems to the FDA at 1-800-FDA-1088.

Ointment

• 500 unit/g

Ointment

• 500 unit/g (3.5 g)

Adult and Pediatric:

Dermal Infections (Superficial)

• Apply the ointment every day or every 8 hours

Ocular Infections

• Apply ¼ to ½ ribbon every 3-4 hours or every 8-12 hours for mild to moderate infections for 7-10 days

Overdose

• Topical or ophthalmic application of bacitracin is unlikely to result in overdose. If bacitracin is ingested orally, it may be toxic to the kidneys.
• Overdose treatment may include symptomatic and supportive care.

Inform your doctor of all medications you are currently taking, who can advise you on any possible drug interactions. Never begin taking, suddenly discontinue, or change the dosage of any medication without your doctor’s recommendation.

• Bacitracin topical has no known severe, serious, mild, or moderate interactions with other drugs.

The drug interactions listed above are not all of the possible interactions or adverse effects. For more information on drug interactions, visit the RxList Drug Interaction Checker.

It is important to always tell your doctor, pharmacist, or health care provider about all prescription and over-the-counter medications you use, as well as the dosage for each, and keep a list of the information. Check with your doctor or healthcare provider if you have any questions about the medication.

• Although no large studies have been conducted in pregnant women, use of topical bacitracin is unlikely to result in adverse fetal events, because there is little systemic absorption from topical application. 
• If bacitracin ointment is used for ophthalmic application during pregnancy, minimum effective dose should be used. In addition, tear duct openings should be blocked (punctal occlusion) to minimize risk of drug exposure to the fetus through tear duct drainage.
• Topical and ophthalmic use of bacitracin may be acceptable for use by nursing mothers because there is limited systemic absorption. Avoid applying on the nipple region.
• Consult with your physician before using any OTC drug including bacitracin ointment if you are pregnant or breastfeeding. 

• Use bacitracin topical or ophthalmic ointment exactly as prescribed.
• Do not use bacitracin topical or ophthalmic ointment for longer than one week, unless directed by your physician.
• Contact your physician if any new infections develop while using bacitracin topical or ophthalmic.
• If you experience any allergic reactions such as itching, burning or rash, discontinue bacitracin topical and contact your physician.
• Store safely out of reach of children.
• In case of accidental ingestion seek medical help or contact Poison Control.