Bacitracin

Administration

• Type: Topical antibiotic
• Dosage Forms: ointment
• Dosage strengths: 500 unit/g
• Routes of Administration: topical, ophthalmic, IM
• Common Trade Names: BACiiM, Baciguent, Bacitracin Ophthalmic Ointment

Adult Dosing

• Apply to wound 2-5 times per day

Pediatric Dosing

• Apply to wound 2-5 times per day
• Staph pneumonia/empyema known to be susceptible to bacitracin: 900-1000 units/kg/day IM in 2 to 3 divided doses

Special Populations

• Pregnancy Rating: C
• Lactation risk: Infant risk minimal
• Renal: no adjustment
• Hepatic: No adjustment

Contraindications

• Allergy to class/drug

Adverse Reactions

Serious

• Renal toxicity (IM only)

Common

• Contact dermatitis

Pharmacology

• Half-life:
• Metabolism:
• Excretion: Urine 10-40%

Mechanism of Action

• Interferes with cell wall peptidoglycan activity
• Active against staph

References

• BACiiM (bacitracin) [prescribing information], Horseheads, NY: X-Gen Pharmaceuticals Inc; June 2008.
• Bacitracin (prescribing information). New York, NY: Pharmacia & Upjohn; September 2015.
• Chia JK, Nakata MM, Park SS, et al, “Use of Bacitracin Therapy for Infection Due to Vancomycin-Resistant Enterococcus faecium,” Clin Infect Dis, 1995, 21(6):1520. [PubMed 8749657]
• Cohen SH, Gerding DN, Johnson S, et al, “Clinical Practice Guidelines for Clostridium difficile Infection in Adults: 2010 Update by the Society for healthcare Epidemiology of American (SHEA) and the Infectious Diseases Society of America (IDSA), Infect Control Hosp Epidemiol, 2010, 31(5):431-55. [PubMed 20307191]
• Damm S. Intraoperative anaphylaxis associated with bacitracin irrigation. Am J Health-Syst Pharm. 2011;68(4):323-327. [PubMed 21289327]
• Dudley MN, McLaughlin JC, Carrington G, et al, “Oral Bacitracin vs Vancomycin Therapy for Clostridium difficile-Induced Diarrhea. A Randomized Double-Blind Trial,” Arch Intern Med, 1986, 146(6):1101-4.
• Elsner P, Pevny I, Burg G. Anaphylaxis induced by topically applied bacitracin. Am J Contact Dermat.1990;1:162-164.