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Bacitracin is a polypeptide antibiotic used on the skin and in the eye that a pharmacy may compound when a prescriber orders it.
Bacitracin is a mixture of related cyclic polypeptide antibiotics made by an organism of the Bacillus subtilis group. It stops susceptible bacteria, mainly gram-positive species such as staphylococci and streptococci, from building their cell walls. Bacitracin first aid ointment is sold without a prescription under the OTC monograph to help prevent infection in minor cuts, scrapes and burns. Prescription bacitracin zinc and polymyxin B sulfate ophthalmic ointment is indicated for superficial infections of the conjunctiva and cornea. StatPearls notes FDA approval of ophthalmic bacitracin for the same use, but Drugs@FDA lists the single-ingredient bacitracin ophthalmic ointment applications as discontinued. In 2020 FDA asked manufacturers to withdraw bacitracin for injection from the market; the request did not affect topical or ophthalmic products. A prescriber might order bacitracin compounded in a vehicle or combination that is not manufactured. Compounded preparations are not FDA-approved and require a prescription.
Topical and ophthalmic bacitracin products have no boxed warning. The first aid label says not to use it in the eyes, over large areas of the body, or if you are allergic to any ingredient; ask a doctor first about deep or puncture wounds, animal bites or serious burns, and stop and ask if you need it longer than 1 week, the condition worsens, or a rash develops. StatPearls notes bacitracin often causes allergic contact dermatitis, anaphylaxis has been reported, and people sensitive to neomycin may also react. The ophthalmic label warns that eye ointments may slow corneal healing. StatPearls notes limited pregnancy data. LactMed considers it low risk while breastfeeding, but only creams or gels, not ointments, should go on the breast. Talk to your prescriber or pharmacist about side effects.
Bacitracin inhibits bacterial cell wall synthesis by preventing dephosphorylation of the lipid pyrophosphate carrier that moves peptidoglycan precursors across the cell membrane; it is bacteriostatic or bactericidal depending on concentration and organism. StatPearls lists activity against Staphylococcus, Streptococcus, Corynebacterium, Clostridium and Actinomyces species and some Neisseria, with most gram-negative organisms resistant; complexing with zinc improves stability. It is poorly absorbed after topical, ophthalmic or oral use but can be absorbed through burned, denuded or granulating skin. Protein binding is minimal, and after intramuscular use it was mainly excreted by the kidneys. Labeled products: OTC first aid bacitracin ointment (OTC monograph M004) and bacitracin zinc and polymyxin B sulfate ophthalmic ointment (ANDA). FDA requested withdrawal of bacitracin for injection, once indicated for infant pneumonia and empyema caused by staphylococci, citing nephrotoxicity and anaphylaxis. StatPearls cites an American Academy of Ophthalmology recommendation of ophthalmic bacitracin ointment for pediculosis palpebrarum, which is not an FDA-approved indication. Prolonged use may allow overgrowth of nonsusceptible organisms, including fungi. Dosing is per prescriber. Monitor for contact dermatitis, hypersensitivity and secondary infection; patch testing may help confirm allergy.
Compounded at Bayview
Patient guides for the preparations we make most often. Each one is compounded to order and requires a prescription.
We do not have a patient page for this ingredient yet. That does not mean we cannot make it. Bayview compounds this ingredient to a prescriber's order, and our full compounding formulary lists every preparation we make. Viewing the formulary requires a prescriber account.
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Every preparation in our formulary that contains this ingredient. Strength, base and dose form are set by the prescription.
Other salt forms of this molecule, and ingredients commonly compounded alongside it.
This page describes an active pharmaceutical ingredient, not a finished drug product. Bayview Pharmacy compounds preparations containing it only on a prescriber's order for an individual patient.
Compounded preparations are not FDA-approved, and the FDA has not evaluated them for safety, effectiveness, or manufacturing quality. Nothing on this page is a claim that any preparation is effective for any condition.
A valid prescription is required. Availability depends on Bayview's licensure in your state. This page is general information, not medical advice. Discuss your situation with a licensed healthcare provider.
Our pharmacists work with prescribers to build preparations around a patient's dose, form and tolerances. Ask us what is possible with this ingredient.
