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Bacitracin Brand Names
AK-Tracin | BaciiM | Baci-Rx | Ocu-Tracin
What is Bacitracin
Bacitracin is an ophthalmic, parenteral, and topical polypeptide antibiotic indicated for superficial ocular infections involving the conjunctiva and/or cornea, infants with pneumonia and empyema due to susceptible staphylococci, and infection prevention in minor cuts, scrapes, or burns, respectively.
It is active mainly against gram-positive bacteria.
In January 2020, the FDA requested the voluntary withdrawal of bacitracin for injection from the market because other effective FDA-approved treatments are available that do not have the same serious risks, including nephrotoxicity, anaphylactic reactions, and the need for repeated intramuscular injections.
Indications
- Actinomyces israelii
- bacterial conjunctivitis
- blepharitis
- blepharoconjunctivitis
- burns
- Clostridium difficile
- Corynebacterium sp.
- Fusobacterium sp.
- keratitis
- keratoconjunctivitis
- Neisseria gonorrhoeae
- Neisseria meningitidis
- ophthalmic infection
- pleural empyema
- pneumonia
- skin abrasion
- skin and skin structure infections
- Staphylococcus aureus (MSSA)
- Streptococcus sp.
- Treponema pallidum
- Treponema vincenti
- vancomycin-resistant enterococci (VRE)
Side Effects
- anaphylactic shock
- anaphylactoid reactions
- azotemia
- blurred vision
- cylindruria
- eosinophilia
- fever
- hematuria
- injection site reaction
- myasthenia
- nausea
- nephrotoxicity
- oliguria
- proteinuria
- pruritus
- rash
- renal failure (unspecified)
- renal tubular necrosis
- respiratory arrest
- respiratory depression
- superinfection
- urticaria
- vomiting
Monitoring Parameters
- serum creatinine/BUN
Contraindications
- breast-feeding
- children
- colitis
- contact lenses
- diarrhea
- fungal infection
- GI disease
- infants
- inflammatory bowel disease
- myasthenia gravis
- neomycin hypersensitivity
- nephrotoxicity
- neuromuscular disease
- ocular exposure
- oliguria
- pregnancy
- pseudomembranous colitis
- pulmonary disease
- renal failure
- renal impairment
- surgery
- ulcerative colitis
Interactions
- Acetaminophen; Aspirin, ASA; Caffeine
- Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
- Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
- Amikacin
- Aminosalicylate sodium, Aminosalicylic acid
- Amphotericin B
- Amphotericin B cholesteryl sulfate complex (ABCD)
- Amphotericin B lipid complex (ABLC)
- Amphotericin B liposomal (LAmB)
- Aspirin, ASA
- Aspirin, ASA; Butalbital; Caffeine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Aspirin, ASA; Caffeine; Dihydrocodeine
- Aspirin, ASA; Caffeine; Orphenadrine
- Aspirin, ASA; Carisoprodol
- Aspirin, ASA; Carisoprodol; Codeine
- Aspirin, ASA; Citric Acid; Sodium Bicarbonate
- Aspirin, ASA; Dipyridamole
- Aspirin, ASA; Omeprazole
- Aspirin, ASA; Oxycodone
- Aspirin, ASA; Pravastatin
- Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Baclofen
- Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Bismuth Subsalicylate
- Bismuth Subsalicylate; Metronidazole; Tetracycline
- Bumetanide
- Capreomycin
- Capsaicin; Metaxalone
- Carisoprodol
- Chlorzoxazone
- Choline Salicylate; Magnesium Salicylate
- Cidofovir
- Cisplatin
- Colistimethate, Colistin, Polymyxin E
- Cyclobenzaprine
- Cyclosporine
- Dantrolene
- Diazepam
- Doravirine; Lamivudine; Tenofovir disoproxil fumarate
- Efavirenz; Emtricitabine; Tenofovir
- Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
- Emtricitabine; Tenofovir disoproxil fumarate
- Ethacrynic Acid
- Foscarnet
- Furosemide
- Gallium Ga 68 Dotatate
- Ganciclovir
- General anesthetics
- Gentamicin
- Hyaluronidase, Recombinant; Immune Globulin
- Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
- Immune Globulin IV, IVIG, IGIV
- Inotersen
- Kanamycin
- Lamivudine; Tenofovir Disoproxil Fumarate
- Loop diuretics
- Magnesium Salicylate
- Mannitol
- Metaxalone
- Methohexital
- Neomycin
- Neuromuscular blockers
- Nonsteroidal antiinflammatory drugs
- OnabotulinumtoxinA
- Oral Contraceptives
- Orphenadrine
- Paromomycin
- Pentamidine
- Polymyxin B
- Polymyxins
- Pyridostigmine
- RimabotulinumtoxinB
- Salicylates
- Salsalate
- Skeletal Muscle Relaxants
- Streptomycin
- Tacrolimus
- Telavancin
- Tenofovir Alafenamide
- Tenofovir, PMPA
- Thiopental
- Tizanidine
- Tobramycin
- Torsemide
- Valganciclovir
- Vancomycin
Mechanism of Action
- Bacitracin is bacteriostatic in action but may be bactericidal, depending on the antibiotic concentration and the susceptibility of the specific organism.
- Bacitracin inhibits the incorporation of amino acids and nucleotides into the cell wall. Bacitracin interferes with the final dephosphorylation step in the phospholipid carrier cycle, which causes impedance of mucopeptide transfer to the growing cell wall. Bacterial plasma membranes are also damaged by bacitracin.
- If bacteria are susceptible to bacitracin, resistance usually develops slowly.
- Bacitracin is active against many gram-positive organisms and some gram-negative organisms. Unlike penicillins, bacitracin is active against protoplasts.
- The gram-positive spectrum includes staphylococci (including some penicillin G-resistant strains), streptococci, anaerobic cocci, clostridia, and corynebacteria. Gonococci, meningococci, and fusobacteria are gram-negative organisms susceptible to bacitracin. Other susceptible organisms include Treponema pallidum, T. vincenti, and Actinomyces israelii.
- However, among systemic diseases, only staphlycoccal infections qualify for consideration for bacitracin therapy. Bacitracin is assayed against a standard and its activity is expressed in units with bacitacin 1 mg having a potency of not less than 50 units.
