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SENSORY ORGANS › OPHTHALMOLOGICALS › ANTIINFECTIVES › Antibiotics
bacitracin
S01AA32
Forms & Strengths
- Ophthalmic ointment 0.04% (w/w)
- Ophthalmic solution 0.5%
- Otic solution 0.5%
- Topical cream 5000 U/g
Adult Dosing
- Ophthalmic ointment: apply a thin strip to the conjunctival sac 4×/day for bacterial conjunctivitis
- Ophthalmic solution: instill 1–2 drops 4×/day
- Otic solution: 2–3 drops 2–3×/day for otitis externa
Pediatric Dosing
- Infants/children <2 y: ophthalmic ointment 2×/day, may increase to 4×/day if severe
- Children 2–12 y: same regimen as adults but monitor for irritation
- Otitis externa in children: 1–2 drops 2×/day
Indications
- Acute bacterial conjunctivitis
- Blepharitis and marginal keratitis
- Superficial ocular surface infections
- Otitis externa (off‑label)
- Minor skin abrasions and burns (topical)
Mechanism of Action
- Binds to C55‑isoprenyl pyrophosphate carrier protein
- Inhibits dephosphorylation step in peptidoglycan synthesis
- Bactericidal against gram‑positive organisms
Contraindications
- Known hypersensitivity to bacitracin or formulation excipients
- Viral, fungal or allergic ocular infections
- Use in patients with severe renal impairment if systemic absorption likely
Adverse Reactions
- Local burning, stinging or itching
- Conjunctival redness and mild edema
- Allergic contact dermatitis (rare)
- Anaphylaxis (very rare)
- Systemic nephrotoxicity only with extensive absorption
Drug Interactions
- Concurrent nephrotoxic agents (e.g., aminoglycosides, amphotericin B) may increase renal risk
- In vitro antagonism with β‑lactam antibiotics (clinical relevance minimal)
- Coadministration with other topical antibiotics may increase irritation
Curated Content: Needs Vetting Before Put to Clinical Use