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Bacitracin Zinc topical

Pronunciation

Class: Antibacterials
VA Class: DE101
CAS Number: 1405-87-4
Brands: Baciguent, Baci-Rx, Bactine First Aid Antibiotic Plus Anesthetic, Band-Aid with Antibiotic, Betadine Brand First Aid Antibiotics + Moisturizer, Betadine Brand First Aid Antibiotics + Pain Reliever, Campho-Phenique First Aid Antibiotic Plus Pain Reliever Maximum Strength, Double Antibiotic, Mycitracin Plus Pain Reliever, Neosporin, Neosporin Plus Maximum Strength First Aid Antibiotic/Pain Relieving, Polysporin, Spectrocin Plus, Triple Antibiotic, Triple Antibiotic Extra, Zeba-Rx

Introduction

Polypeptide antibiotic.

Uses for Bacitracin Zinc

Superficial Skin Infections

Topically (alone or in combination with other anti-infectives) to prevent or treat superficial skin infections caused by susceptible organisms.a

May be useful for preventing infection in minor skin injuries (e.g., cuts, scrapes, burns).a

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Role of topical anti-infectives for treatment of superficial skin infections has not been fully elucidated.a

Self-medication with topical anti-infectives to treat superficial skin infections currently is not recommended.a

Treatment of serious or extensive skin infections usually requires systemic anti-infective therapy.a

Bacitracin Zinc Dosage and Administration

Administration

Apply ointment or powder topically to cleansed area.a

May cover affected area with a sterile bandage following use of ointments, powders, or sprays.a

Has been used for topical compresses in 0.9% sodium chloride injection or sterile water for injection (250–1000 units/mL).a

Dosage

Adults

Superficial Skin Infections
Topical

Ointment: Apply amount equal to the surface area of a fingertip to the affected area 1–3 times daily.a

Powder: Use a light dusting on affected area 1–3 times daily.a

Prescribing Limits

Maximum 1 week of use unless directed by a physician.a

Cautions for Bacitracin Zinc

Contraindications

  • Known history of hypersensitivity to bacitracin or any ingredients in the formulations.a

  • Avoid use in atopic individuals.a

Warnings/Precautions

Sensitivity Reactions

Rashes and allergic anaphylactoid reactions have occurred, but topical application has low order of toxicity.a

If itching, burning, inflammation, or other signs of sensitivity occur, discontinue use and consult a clinician.a

Sensitivity to neomycin also may indicate sensitivity to bacitracin.a

Patch testing (e.g., 1% bacitracin in petrolatum) may be useful in diagnosing suspected allergic contact dermatitis when hypersensitivity to other topical antibiotics (e.g., neomycin) is suspected.a

General Precautions

Overgrowth of nonsusceptible organisms, particularly Candida, may occur; institute appropriate therapy if superinfection occurs.a

Topical use of bacitracin should not replace appropriate surgical management or other measures.a

Consider systemic anti-infective therapy if a deep-seated infection is present.a

Corticosteroids in topical anti-infective combination preparations may mask the clinical signs of bacterial, fungal, or viral infections, or may suppress hypersensitivity reactions to the antibiotics or other ingredients in the formulations; weigh benefits against risks.a

Use of Fixed Combination

When used in fixed combination with other agents, consider the cautions, precautions, and contraindications associated with the concomitant agents.

Specific Populations

Pregnancy

Category C.b

Lactation

Not known whether topical bacitracin is distributed into milk.b

Bacitracin Zinc Pharmacokinetics

Absorption

Bioavailability

Not absorbed to any appreciable extent from intact or denuded skin, wounds, or mucous membranes.a

Stability

Storage

Topical

Ointment

15–30°C.a

Powder

2–15°C; protect from direct sunlight.a

Compatibility

For information on systemic interactions resulting from concomitant use, see Interactions.

Topical

Vehicle Compatibility

Compatiblea

Lanolin

Paraffins

Petrolatum

White wax

Incompatible

Water-miscible bases

Mixture Compatibility

Incompatiblea

Benzalkonium chloride

Benzoates

Cetylpyridinium chloride

Heavy metal salts

Salicylates

Sodium lauryl sulfate

Tannates

Actions and Spectrum

  • Polypeptide antibiotic produced by Bacillus subtilis; consists of 3 separate compounds, bacitracin A (chief constituent), B, and C.a

  • Bactericidal or bacteriostatic, depending on concentration attained at infection site and infecting organism’s susceptibility.a

  • Inhibits bacterial cell-wall synthesis, damages the bacterial plasma membrane and is active against protoplasts.a

  • Active against many gram-positive organisms such as staphylococci (including some penicillin-resistant staphylococci), streptococci, anaerobic cocci, corynebacteria, and clostridia; in vitro, bacitracin 0.05–5 mcg/mL inhibits most susceptible strains of Staphylococcus aureus.a

  • Active against gonococci, meningococci, and fusobacteria, but not most other gram-negative organisms.a

  • Also active against Actinomyces israelii, Treponema pallidum, and T. vincenti.a

  • The activity of bacitracin is not impaired by blood, pus, necrotic tissue, or large inocula.a

  • In susceptible bacteria, bacitracin resistance seldom occurs; if it does occur, it emerges slowly.a

  • Staphylococci, including penicillin-resistant staphylococci, are increasingly becoming resistant.a

  • No cross-resistance with other antibiotics.a

Advice to Patients

  • Importance of discontinuing bacitracin and consulting a clinician if itching, burning, inflammation, or other signs of sensitivity occur.a

  • Importance of understanding that topical bacitracin preparations are intended for external use only.a

  • Importance of not using in the eyes or applying over large areas of the body.

  • Importance of first consulting a clinician when considering use for self-medication for deep or puncture wounds, animal bites, or serious burns.a

  • Importance of discontinuing use and consulting a clinician if condition persists or worsens when used to prevent infection in minor skin injuries (e.g., cuts, scrapes, burns).a

  • Importance of not using for >1 week unless directed by a clinician.a

  • Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.

  • Importance of informing patients of other important precautionary information.a (See Cautions.)

Preparations

Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.

* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name

Bacitracin

Routes

Dosage Forms

Strengths

Brand Names

Manufacturer

Bulk

Powder*

Topical

Ointment

500 units/g*

Baciguent

Lee Pharmaceuticals

* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name

Bacitracin Combinations

Routes

Dosage Forms

Strengths

Brand Names

Manufacturer

Topical

Ointment

400 units/g with Neomycin Sulfate 0.5% (0.35% of neomycin) and Polymyxin B Sulfate 5000 units (of polymyxin B) per g*

Triple Antibiotic Ointment

Alpharma, Pfeiffer

Bacitracin Zinc

Routes

Dosage Forms

Strengths

Brand Names

Manufacturer

Bulk

Powder

Topical

Ointment

500 units (of bacitracin) per g

Bacitracin Zinc Ointment

Alpharma, Rugby

* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name

Bacitracin Zinc Combinations

Routes

Dosage Forms

Strengths

Brand Names

Manufacturer

Topical

Ointment

400 units (of bacitracin) per g with Neomycin Sulfate 0.5% (0.35% of neomycin) and Polymyxin B Sulfate 5000 units (of polymyxin B) per g

Neosporin

Pfizer

Triple Antibiotic Ointment

500 units (of bacitracin) per g with Lidocaine 4%, Neomycin Sulfate 0.5% (0.35% of neomycin), and Polymyxin B Sulfate 10,000 units (of polymyxin B) per g*

Bactine First Aid Antibiotic Plus Anesthetic

Bayer

Campho-Phenique First Aid Antibiotic Plus Pain Reliever Maximum Strength

Bayer

Mycitracin Plus Pain Reliever (with parabens)

J&J Consumer

Spectrocin Plus

Numark

Triple Antibiotic Extra

IVAX

Triple Antibiotic Plus Ointment Maximum Strength

Alpharma, G&W, Major

Triple Antibiotic with Lidocaine Ointment Maximum Strength

Clay-Park, Moore

500 units (of bacitracin) per g with Neomycin Sulfate 0.5% (0.35% of neomycin) and Polymyxin B Sulfate 10,000 units (of polymyxin B) per g

Mycitracin Triple Antibiotic First Aid Ointment Maximum Strength (with parabens)

J&J Consumer

500 units (of bacitracin) per g with Polymyxin B Sulfate 10,000 units (of polymyxin B) per g and Pramoxine Hydrochloride 1%

Betadine Brand First Aid Antibiotics + Pain Reliever

Purdue Frederick

500 units (of bacitracin) per g, with Neomycin Sulfate 0.5% (0.35% of neomycin), Polymyxin B Sulfate 10,000 units (of polymyxin B) per g, and Pramoxine Hydrochloride 1%

Neosporin Plus Maximum Strength First Aid Antibiotic/Pain Relieving Ointment

Pfizer

500 units (of bacitracin) per g with Polymyxin B Sulfate 10,000 units (of polymyxin B) per g

Bacitracin-Polymyxin Ointment

Clay-Park, Major, Rugby

Band-Aid with Antibiotic Ointment

J&J Consumer

Betadine Brand First Aid Antibiotics + Moisturizer Ointment

Purdue Frederick

Double Antibiotic Ointment

Fougera

Polysporin Ointment

Pfizer

Powder

500 units (of bacitracin) per g with Polymyxin B Sulfate 10,000 units (of polymyxin B) per g

Polysporin Powder

Pfizer

Anti-infective combinations including bacitracin are also commercially available in combination with corticosteroids for topical use.

AHFS DI Essentials. © Copyright, 2004-2014, Selected Revisions July 1, 2005. American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland 20814.

References

a. AHFS drug information 2004. McEvoy GK, ed. Bacitracin. Bethesda, MD: American Society of Health-System Pharmacists; 2004:3305-6.

b. Briggs GG, Freeman RK, Yaffe SJ. Drugs in pregnancy and lactation. 6th ed. Philadelphia: Lippincott Williams & Wilkins; 2002: 120/b.

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