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Bacitracin (ophthalmic): Drug information

Bacitracin (ophthalmic): Drug information
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For additional information see "Bacitracin (ophthalmic): Patient drug information" and "Bacitracin (ophthalmic): Pediatric drug information"

For abbreviations, symbols, and age group definitions show table
Pharmacologic Category
  • Antibiotic, Ophthalmic
Dosing: Adult
Ocular infections

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.

Dosing: Older Adult

Refer to adult dosing.

Dosing: Pediatric

(For additional information see "Bacitracin (ophthalmic): Pediatric drug information")

Ophthalmic infections

Ophthalmic infections: Infants, Children, and Adolescents: Ophthalmic: Apply ribbon 1 to 3 times daily.

Adverse Reactions

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)

Contraindications

Hypersensitivity to bacitracin or any component of the formulation

Warnings/Precautions

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.

Dosage Forms Considerations

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).

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Ointment, Ophthalmic [preservative free]:

Generic: 500 units/g (3.5 g)

Generic Equivalent Available: US

Yes

Pricing: US

Ointment (Bacitracin Ophthalmic)

500 units/g (per gram): $37.05

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Administration: Adult

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.

Administration: Pediatric

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.

Use: Labeled Indications

Ocular infections: Treatment of blepharitis and associated bacterial overgrowth; treatment of superficial ocular infections involving the conjunctiva or cornea due to susceptible organisms

Medication Safety Issues
Sound-alike/look-alike issues:

Bacitracin may be confused with Bactrim, Bactroban

Metabolism/Transport Effects

None known.

Drug Interactions

There are no known significant interactions.

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

Breastfeeding Considerations

Bacitracin is not absorbed systemically following ophthalmic administration (Robert 2001).

Mechanism of Action

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).

Pharmacokinetics (Adult Data Unless Noted)

Absorption: Topical: Negligible

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  2. Bacitracin ophthalmic [prescribing information]. Allegan, MI: Perrigo; August 2021.
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  7. Hätinen A, Teräsvirta M, Fräki JE. Contact allergy to components in topical ophthalmologic preparations. Acta Ophthalmol (Copenh). 1985;63(4):424-426. [PubMed 4050363]
  8. Pichichero ME. Bacterial conjunctivitis in children: antibacterial treatment options in an era of increasing drug resistance. Clin Pediatr (Phila). 2011;50(1):7-13. doi: 10.1177/0009922810379045. [PubMed 20724317]
  9. Robert PY, Adenis JP. Comparative review of topical ophthalmic antibacterial preparations. Drugs. 2001;61(2):175-185. doi: 10.2165/00003495-200161020-00003. [PubMed 11270936]
  10. Samples JR, Meyer SM. Use of ophthalmic medications in pregnant and nursing women. Am J Ophthalmol. 1988;106(5):616-623. [PubMed 2903673]
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  12. Suzuki M, Yamada K, Nagao M, et al. Antimicrobial ointments and methicillin-resistant Staphylococcus aureus USA300. Emerg Infect Dis. 2011;17(10):1917-1920. doi: 10.3201/eid1710.101365. [PubMed 22000371]
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