Gramicidin D
Also known as: Bacitracin-associated antibiotic, Gramicidin, Gramicidin D, Neosporin Ophthalmic (combination), Sofradex (combination)
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Summary
A mixture of linear 15‑residue peptides (gramicidin A, B, C) used topically as an antibacterial agent in creams and ointments. Not suitable for systemic administration due to hemolytic toxicity.
Mechanism of Action
Forms voltage‑dependent ion channels in bacterial cell membranes, disrupting ion gradients and causing rapid cell death.
Routes of Administration
Goals & Uses
- Treatment of superficial skin infectionsAntimicrobialModerate
- Topical treatment of superficial bacterial skin infectionsAntibacterialHigh
- Treatment of superficial ocular bacterial infectionsAntimicrobial / OphthalmicHigh
- Prevention of gram-positive bacterial colonizationAntimicrobial ProphylaxisModerate
Contraindications
- Hypersensitivity to gramicidinAllergyHigh
- Systemic administrationRoute Of AdministrationHigh
- Hypersensitivity to gramicidin or formulation excipientsAllergy / ImmunologyHigh
- Extensive or deep skin lesionsWound TypeModerate
- Use in perforated tympanic membrane (otic use)Anatomical / SafetyHigh
Adverse Effects
- Local skin irritationDermatologicalCommon
- HemolysisHematologicRare
- Contact dermatitis / hypersensitivityImmunologicUncommon
- Hemolysis (systemic exposure)HematologicRare
- Allergic contact dermatitisImmunologicalUncommon
- Local irritation (stinging, burning)Local ReactionCommon
- NephrotoxicityRenalRare
Drug Interactions
- Polymyxin B (combination product)Low
- Other topical antibiotics (e.g., neomycin)Moderate
- Neomycin (combination product)Low
Population Constraints
- Infants <2 monthsAgeAbsolute
- Pregnant or breastfeeding womenReproductiveRelative
- Pregnant womenReproductiveRelative
- Pediatric patients (ophthalmic use)AgeRelative
- Patients with history of antibiotic hypersensitivityAllergyRelative
Regulatory Status
- European UnionApprovedApproved: Topical antibacterial therapyMarketed as a component of topical antibiotic creams.
- United StatesApprovedApproved: Topical treatment of superficial bacterial skin infectionsAvailable in OTC combination products (e.g., bacitracin‑gramicidin ointment).
- United KingdomApprovedApproved: Superficial ocular infections, Otitis externa (combination products, intact tympanic membrane only)Available in combination products such as Sofradex (gramicidin + framycetin + dexamethasone) for ophthalmic and otic use.
Approved for topical use in the United States and Europe; contraindicated for extensive skin lesions and systemic exposure.
Evidence & Sources
No sources recorded yet.
Frequently Asked Questions
What is Gramicidin D?
A mixture of linear 15‑residue peptides (gramicidin A, B, C) used topically as an antibacterial agent in creams and ointments. Not suitable for systemic administration due to hemolytic toxicity.
What is Gramicidin D used for?
Gramicidin D is educationally associated with: Treatment of superficial skin infections, Topical treatment of superficial bacterial skin infections, Treatment of superficial ocular bacterial infections, Prevention of gram-positive bacterial colonization. Educational only — not medical advice.
How is Gramicidin D administered?
Recorded routes of administration: Ophthalmic, Topical.
What are the potential side effects of Gramicidin D?
Reported adverse effects include: Local skin irritation, Hemolysis, Contact dermatitis / hypersensitivity, Hemolysis (systemic exposure), Allergic contact dermatitis, Local irritation (stinging, burning), Nephrotoxicity. This list is not exhaustive — consult a qualified clinician.
Who should avoid Gramicidin D?
Recorded contraindications: Hypersensitivity to gramicidin, Systemic administration, Hypersensitivity to gramicidin or formulation excipients, Extensive or deep skin lesions, Use in perforated tympanic membrane (otic use). Consult a qualified clinician before use.