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Bacitracin (Ophthalmic)

Pronunciation

(bas i TRAY sin)

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Ointment, Ophthalmic:

Generic: 500 units/g (1 g [DSC], 3.5 g)

Pharmacologic Category

  • Antibiotic, Ophthalmic

Pharmacology

Inhibits bacterial cell wall synthesis by preventing transfer of mucopeptides into the growing cell wall

Use: Labeled Indications

Superficial ocular infections: Treatment of superficial ocular infections involving the conjunctiva or cornea due to susceptible organisms

Contraindications

Hypersensitivity to bacitracin or any component of the formulation

Dosing: Adult

Ophthalmic infection: Ophthalmic: Apply 1 to 3 times daily

Dosing: Geriatric

Refer to adult dosing.

Dosing: Pediatric

Ophthalmic infection: Children and Adolescents: Ophthalmic: Refer to adult dosing.

Administration

Ophthalmic: For topical ophthalmic use only; apply directly into conjunctival sac. For blepharitis, after carefully removing all scales and crusts, apply uniformly over lid margins. Avoid gross contamination of ointment during application.

Storage

Store at 20°C to 25°C (68°F to 77°F).

Drug Interactions

There are no known significant interactions.

Adverse Reactions

1% to 10%: Hypersensitivity: Hypersensitivity reaction (7% [Hätinen, 1985])

Postmarketing and/or case reports (Limited to important or life-threatening): Contact dermatitis (Pichichero, 2011)

Warnings/Precautions

Concerns related to adverse effects:

• Bacterial overgrowth: Prolonged use may result in overgrowth of nonsusceptble organisms, particularly fungi; if new infection develops, initiate appropriate therapy.

• Hypersensitivity/anaphylaxis: Use with caution in patients who have been previously exposed to bacitracin; anaphylactic reactions have occurred on repeat exposure (Elsner, 1990; Farley, 1995).

Other warnings/precautions:

• Appropriate use: Should not be used in deep seated ocular infections or if infection is likely to become systemic.

Pregnancy Considerations

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 punctual occlusion to decrease potential exposure to the fetus (Samples, 1988).

Patient Education

• Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)

• Patient may experience blurred vision or watery eyes. Have patient report immediately to prescriber vision changes, eye pain, or severe eye irritation (HCAHPS).

• Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.

Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for health care professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience, and judgment in diagnosing, treating, and advising patients.

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