Version May 2024
Ophthalmic infections: Infants, Children, and Adolescents: Ophthalmic: Apply ribbon 1 to 3 times daily.
(For additional information see "Bacitracin (ophthalmic): Drug information")
Ocular infections: Ophthalmic:
Blepharitis: Apply twice daily and at bedtime.
Superficial infections of the conjunctiva and/or cornea: Apply up to every 3 to 4 hours for 10 days as determined by severity of infection.
The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.
1% to 10%: Hypersensitivity: Hypersensitivity reaction (7% [Hätinen 1985])
<1%, postmarketing, and/or case reports: Contact dermatitis (Pichichero 2011)
Hypersensitivity to bacitracin or any component of the formulation
Concerns related to adverse effects:
• Bacterial overgrowth: Prolonged use or use in absence of infectious presence may result in overgrowth of nonsusceptible organisms, particularly fungi; if new infection develops, initiate appropriate therapy.
• Blurred vision: May cause blurred vision, which may impair physical or mental abilities; patients must be cautioned about performing tasks that require clear vision (eg, operating machinery or driving).
• Hypersensitivity/anaphylaxis: Use with caution in patients who have been previously exposed to bacitracin; contact dermatitis (Pichichero 2011) has been reported and may take several days of use to develop. Discontinue use if signs of an allergic sensitization reaction are noted, including itching, swelling, and conjunctival erythema.
Special populations:
• Contact lens wearers: Contact lenses should not be worn during treatment.
Other warnings/precautions:
• Appropriate use: Should not be used in deep seated ocular infections or if infection is likely to become systemic. Patients who do not respond to topical ophthalmic bacitracin treatment following 10 days of use should be reevaluated to ascertain appropriateness of continued antibiotic use.
Bacitracin may also be compounded extemporaneously for subconjunctival injection and topical application to the eye in strengths of between 5,000 to 10,000 units/mL (Allen 2010).
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Ointment, Ophthalmic [preservative free]:
Generic: 500 units/g (3.5 g)
Yes
Ointment (Bacitracin Ophthalmic)
500 units/g (per gram): $37.05
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Ophthalmic: For topical ophthalmic use only; apply directly to conjunctival sac; avoid gross contamination of ointment during application. For blepharitis: After carefully removing all scales and crusts, apply uniformly over lid margins.
Ophthalmic: For topical ophthalmic use only; do not inject into the eye. Avoid contamination of ointment during application. Avoid excess ointment application. Patients should be instructed on proper administration of eye ointments. Do not touch the tip of the applicator to any part of the eye or surrounding adjacent areas.
Blepharitis: After carefully removing all scales and crusts, apply thin film uniformly over lid margins.
Superficial infections of the conjunctiva and/or cornea: Apply thin ¼ inch strip directly into conjunctival sac.
Store at 20°C to 25°C (68°F to 77°F).
Treatment of superficial ocular infections involving the conjunctiva or cornea due to bacterial infections (has activity against gram-positive bacilli) (FDA approved in pediatric patients [age not specified] and adults).
Bacitracin may be confused with Bactrim, Bactroban
None known.
There are no known significant interactions.
Bacitracin is not absorbed systemically following ophthalmic administration (Robert 2001). If ophthalmic agents are needed during pregnancy, the minimum effective dose should be used in combination with punctal occlusion to decrease potential exposure to the fetus (Samples 1988).
A cyclic peptide antibiotic that inhibits bacterial cell wall synthesis by preventing transfer of mucopeptides into the growing cell wall. Bacitracin is bacteriostatic in nature, but may be bactericidal depending on the antibiotic concentration and the susceptibility of the organism. The antibacterial spectrum is primarily gram positive with activity against staphylococci (including some penicillin G resistant strains), streptococci, anaerobic cocci, Clostridia, Corynebacterium, gonococci, meningococci, and fusobacteria. Other susceptible organisms include Treponema pallidum, Treponema vincentii, and Actinomyces israelii. Development of bacitracin resistance is rare; however, resistance to Staphylococcus aureus has been reported (Suzuki 2011).
Absorption: Topical: Negligible
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