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Action/Kinetics:
Produced by
Bacillus subtilis. Interferes with synthesis of cell wall, preventing incorporation of amino acids and nucleotides. Is bactericidal, bacteriostatic, and active against protoplasts. Not absorbed from the GI tract. When given parenterally, drug is well distributed in pleural and ascitic fluids. High nephrotoxicity. Systemic use is restricted to infants (see
Uses). Carefully evaluate renal function prior to, and daily, during use.
Peak plasma levels: IM, 0.2-2 mcg/mL after 2 hr. From 10% to 40% is excreted in the urine after IM administration.
Uses:
Parenteral: Limited to the treatment of staphylococcal pneumonia and staphylococcus-induced empyema in infants.
Topical: Prophylaxis or treatment of infections in minor cuts, wounds, burns, and skin abrasions. As an aid to healing and for treating superficial infections of the skin due to susceptible organisms.
Ophthalmic: Effective against species of
Staphylococcus
S. aureus, Streptococcus, S. pneumoniae, S. pyogenes, Corynebacterium, Neisseria, N. gonorrhoeae and beta-hemolytic streptococci. Do not use topical antibiotics in deep-seated ocular infections or in those that are likely to become systemic.
Contraindications:
Hypersensitivity or toxic reaction to bacitracin. Pregnancy. Epithelial herpes simplex keratitis, vaccinia, varicella, mycobacterial eye infections, fungal diseases of the eye.
Special Concerns:
Ophthalmic ointments may retard corneal epithelial healing. Prolonged or repeated use may result in bacterial or fungal overgrowth of nonsusceptible organisms leading to a secondary infection.
Side Effects:
Parenteral use:
Nephrotoxicity due to tubular and glomerular necrosis, renal failure; toxic reactions; N&V.;
Topical use: Allergic contact dermatitis, superinfection.
Ophthalmic use: Transient burning, stinging, itching, irritation, inflammation, angioneurotic edema, urticaria, vesicular and maculopapular dermatitis.
Drug Interactions:
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Aminoglycosides / Additive nephrotoxicity and neuromuscular blocking activity
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Anesthetics /
Neuromuscular blockade
possible muscle paralysis
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Neuromuscular blocking agents / Additive neuromuscular blockade
possible muscle paralysis
How Supplied:
Bacitracin intramuscular:
Powder for Injection: 50,000 u/vial
Bacitracin ointment:
Ointment: 500 U/g
Bacitracin ophthalmic ointment:
Ointment: 500 U/g
Dosage
?IM Only
Infants, 2.5 kg and below: 900 units/kg/day in two to three divided doses;
infants over 2.5 kg: 1,000 units/kg/day in two to three divided doses.
?Ophthalmic Ointment (500 units/g)
Acute infections.
1/2 in. in lower conjunctival sac q 3-4 hr until improvement occurs. Reduce treatment before the drug is discontinued.
Mild to moderate infections.
1/2 in. b.i.d.-t.i.d.
?Topical Ointment (500 units/g)
Apply a small amount equal to the surface area of a fingertip 1-3 times/day after cleaning the affected area. Do not use for more than 1 week.
