Bacitracin
Also known as: BAC, Baciguent, BACiiM, Bacitracin A, Bacitracin zinc, Bacitracin-Polymyxin B, Neosporin (combination), Polysporin (combination)
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Summary
Bacitracin is a mixture of cyclic polypeptide antibiotics used topically for superficial skin infections; systemic use is limited due to nephrotoxicity.
Mechanism of Action
Inhibits bacterial cell wall synthesis by blocking dephosphorylation of bactoprenol phosphate, preventing peptidoglycan precursor translocation.
Routes of Administration
Goals & Uses
- Treatment of superficial skin infectionsAntimicrobialHigh
- Clostridium difficile infection (oral)Antimicrobial / GILow
- Systemic gram-positive infections (IM)Antimicrobial / SystemicLow
- Prevention of minor skin infectionAntimicrobial / Wound CareHigh
- Ophthalmic infections (conjunctivitis, blepharitis)Antimicrobial / OphthalmologyModerate
- treat superficial bacterial skin infectionsAntibacterialHigh
Contraindications
- hypersensitivity to bacitracinAllergyHigh
- Deep wounds, puncture wounds, or serious burns (OTC topical)Wound TypeModerate
- Severe renal impairment (systemic use)Organ ImpairmentModerate
- Known hypersensitivity to bacitracinAllergyHigh
- Renal impairment (systemic/IM use)RenalHigh
Adverse Effects
- AnaphylaxisImmunologicRareSevere life-threatening allergic reaction
- Contact dermatitis / Allergic sensitizationDermatologic / ImmunologicUncommon
- Contact dermatitisDermatologicalCommon
- Nausea/vomitingGastrointestinalRare
- Nausea and vomitingGastrointestinalUncommon
- Local injection site painLocal ReactionCommon
- Neuromuscular blockadeNeuromuscularRare
- NephrotoxicityRenalUncommon
Drug Interactions
- Loop diureticsLow
- Colistin / PolymyxinsModerate
- AminoglycosidesModerate
- Neuromuscular blocking agents (e.g., succinylcholine, vecuronium)High
- Other nephrotoxic agents (e.g., aminoglycosides, vancomycin, NSAIDs)High
Population Constraints
- PregnancyReproductive SafetyRelative
- Neonates (systemic use)PediatricRelative
- Patients with renal impairmentOrgan ImpairmentAbsolute
- Large surface area applicationSpecial UseRelative
- Pregnant womenReproductiveRelative
- NeonatesPediatricRelative
Regulatory Status
- European UnionApprovedApproved: topical treatment of minor skin infectionsAvailable as OTC ointment; systemic use restricted.
- United StatesApprovedApproved: topical treatment of minor skin infectionsOTC for topical formulations; intravenous use is investigational/compounded.
- United KingdomApprovedApproved: Topical skin and wound infections, Ophthalmic infectionsAvailable OTC and as prescription topical/ophthalmic preparations in the UK.
FDA-approved for topical and ophthalmic use OTC; intramuscular formulation is prescription-only and rarely used due to nephrotoxicity risk. Banned as a livestock feed additive in the EU. WHO classifies bacitracin as 'not critically important' for human medicine.
Evidence & Sources
No sources recorded yet.
Frequently Asked Questions
What is Bacitracin?
Bacitracin is a mixture of cyclic polypeptide antibiotics used topically for superficial skin infections; systemic use is limited due to nephrotoxicity.
What is Bacitracin used for?
Bacitracin is educationally associated with: Treatment of superficial skin infections, Clostridium difficile infection (oral), Systemic gram-positive infections (IM), Prevention of minor skin infection, Ophthalmic infections (conjunctivitis, blepharitis), treat superficial bacterial skin infections. Educational only — not medical advice.
How is Bacitracin administered?
Recorded routes of administration: Intramuscular, Intravenous, Ophthalmic, Oral, Topical.
What are the potential side effects of Bacitracin?
Reported adverse effects include: Anaphylaxis, Contact dermatitis / Allergic sensitization, Contact dermatitis, Nausea/vomiting, Nausea and vomiting, Local injection site pain, Neuromuscular blockade, Nephrotoxicity. This list is not exhaustive — consult a qualified clinician.
Who should avoid Bacitracin?
Recorded contraindications: hypersensitivity to bacitracin, Deep wounds, puncture wounds, or serious burns (OTC topical), Severe renal impairment (systemic use), Known hypersensitivity to bacitracin, Renal impairment (systemic/IM use). Consult a qualified clinician before use.