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Indications and Dosage
Intramuscular
Staphylococcal infections Child: Infant ≤2.5 kg: 900 U/kg daily in 2 or 3 divided doses; >2.5 kg: 1,000 U/kg daily in 2 or 3 divided doses. Ophthalmic Ophthalmic infections Adult: Apply thinly to conjunctival sac 1-3 times daily. Child: Same as adult dose. Topical/Cutaneous Local infections Adult: Apply thinly to affected area 1-3 times daily.
Child: Same as adult dose. |
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Reconstitution
Reconstitute w/ NaCl 0.9% inj containing 2% procaine HCl. Concentration of soln should be between 5,000-10,000 U/mL.
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Incompatibility
Slowly inactivated in bases containing stearyl alcohol, cholesterol, polyoxyethylene derivatives and Na laurilsulfate. Rapidly inactivated in bases containing water, macrogols, propylene glycol, glycerol, cetylpyridinium Cl, benzalkonium Cl, ichthammol, phenol and tannic acid.
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Contraindications
Hypersensitivity to bacitracin.
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Special Precautions
Patient w/ deep puncture wounds, bites or serious burns (topical). Prolonged use may result in overgrowth of nonsusceptible organisms, including fungi. Renal impairment (IM). Pregnancy and lactation.
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Adverse Reactions
Nephrotoxicity, albuminuria, cylinduria, azotemia, nausea, vomiting, skin rashes, pain at inj site (IM); hypersensitivity reactions.
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IM/Ophth/Parenteral/PO/Topical: C
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Patient Counseling Information
Maintain adequate fluid intake and urinary output.
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Monitoring Parameters
Perform urinalysis, renal function test and monitor urine output during IM use.
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Drug Interactions
Increased risk of nephrotoxicity when used w/ other nephrotoxic drugs (e.g. colistin, kanamycin, neomycin, polymyxin B, and streptomycin). May enhance the action of neuromuscular blocking agents and anaesth.
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Action
Description:
Mechanism of Action: Bacitracin inhibits bacterial cell wall synthesis by preventing transfer of mucopeptides into the growing cell wall. It also damages bacterial plasma membrane and active against protoplasts. Pharmacokinetics: Absorption: Rapidly absorbed (IM). Distribution: Widely distributed into body tissues and readily diffuses into pleural and ascetic fluids. Excretion: Via urine, approx 10-40%. |
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Chemical Structure
 Source: National Center for Biotechnology Information. PubChem Database. CID=11980094, https://pubchem.ncbi.nlm.nih.gov/compound/Bacitracin-methylene-disalicylate (accessed on Jan. 21, 2020) |
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Storage
Topical oint: Store between 15-30°C. Powder for inj: Store between 2-8°C. Ophth oint: Store between 20-25°C.
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MIMS Class
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ATC Classification
J01XX10 - bacitracin ; Belongs to the class of other antibacterials. Used in the systemic treatment of infections.
D06AX05 - bacitracin ; Belongs to the class of other topical antibiotics used in the treatment of dermatological diseases. |
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References
Anon. Bacitracin (Ophthalmic). Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 02/08/2016. Anon. Bacitracin (Systemic). Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 02/08/2016. Anon. Bacitracin (Topical). Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 02/08/2016. Bacitracin inj (Xellia Pharmaceuticals ApS). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 02/08/2016. Bacitracin ointment (Blossom Pharmaceuticals). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 02/08/2016. Buckingham R (ed). Bacitracin. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 02/08/2016. McEvoy GK, Snow EK, Miller J et al (eds). Bacitracin, Bacitracin Zinc (Topical). AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 02/08/2016.
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